A double barrel colostomy is a surgical procedure that involves the creation of two separate stomas on the abdomen. This procedure is typically performed when a section of the colon needs to be bypassed due to disease, injury, or other medical conditions. As a nurse, understanding the intricacies of a double barrel colostomy is essential for providing effective care to patients undergoing this procedure.
What is a Double Barrel Colostomy?
A
double barrel colostomy involves dividing the colon into two ends. Each end is brought through an opening in the abdominal wall, creating two stomas. The proximal stoma (functional end) continues to pass stool, while the distal stoma (nonfunctional end) only drains mucus from the lower part of the colon. This setup is often temporary, allowing the colon to heal from surgery or inflammation.
Indications for a Double Barrel Colostomy
There are several
indications for performing a double barrel colostomy. These include conditions such as
colorectal cancer,
diverticulitis, inflammatory bowel disease, traumatic injury to the colon, or as part of a planned surgical approach to allow healing or rest of the bowel.
Nursing Assessment and Care
Nursing care for patients with a double barrel colostomy involves a comprehensive
assessment and implementation of a care plan that addresses physical and psychological needs. Key aspects include:
Stoma Assessment: Nurses must regularly assess stoma color, size, and output. A healthy stoma is typically moist, pink, or red, and raised above the skin surface.
Skin Care: Protecting the skin around the stoma (peristomal skin) is crucial to prevent irritation and infection. Use appropriate
skin barriers and ensure the ostomy appliance fits correctly.
Education: Educating patients and their families on colostomy care, including how to manage the appliance, recognize signs of complications, and maintain nutritional and fluid balance, is imperative.
Managing Complications
Complications can arise following a double barrel colostomy, and nurses play a critical role in early detection and management. Common complications include: Stomal Prolapse: This occurs when the stoma protrudes excessively. Immediate intervention may be required to prevent further complications.
Parastomal Hernia: Nurses should monitor for bulging around the stoma site and educate patients on preventive measures, such as avoiding heavy lifting.
Infection: Signs of infection include redness, swelling, or discharge around the stoma. Prompt action is needed to address these symptoms.
Patient and Family Support
The psychological impact of living with a double barrel colostomy can be significant. Nurses should provide emotional support and resources to help patients and their families adjust to lifestyle changes. Encouraging participation in
support groups can also be beneficial.
Reversal of Double Barrel Colostomy
In many cases, a double barrel colostomy is temporary, and reversal surgery may be planned once the underlying condition is resolved. Nurses should prepare patients for what to expect during the
reversal process, including potential risks and recovery expectations.
Conclusion
Providing comprehensive nursing care for patients with a double barrel colostomy requires a thorough understanding of the procedure and its implications. Through careful assessment, management of potential complications, patient education, and emotional support, nurses can significantly improve patient outcomes and quality of life.
