Enterostomal Therapy & Wound Management

Enterostomal Therapy

At Fairfax Colon & Rectal Surgery, we employ the most modern techniques and have the expertise which results in the patient being able to avoid the need for a colostomy or ileostomy in the overwhelming majority of cases. Despite this, there are situations in which the patient is best treated with creation of either a temporary of permanent stoma. We feel it is our duty to provide these patients with the utmost care and assistance in learning all the ins and outs of living with a stoma. If it is anticipated that the patient will need to have an ileostomy or colostomy created during their surgery we will arrange for a pre-operative visit with the enterostomal therapy nurses at Fairfax Hospital.

When a patient is going to have a stoma it is imperative that it be located in an optimal position on their abdominal wall so that they can see it and care for it easily once they are home. The Enterostomal Nurse sees our patients prior to their surgery and by examining the contour of their abdomen while they stand, lye down and sit selects the optimal location for their stoma. This area is marked with permanent marker for the time of the surgery. At this pre-operative visit the Enterostomal Nurse will also begin the instruction the patient will receive on all the different aspects of care that need to covered regarding life with the stoma.

While in the hospital, the patient will receive initial instructions on how to change the ostomy appliance (bag) and care for the skin around the stoma. The ostomy nurses can also help put the patient and their family in touch with other resources to learn more about life with a stoma. Many of our patients have found the local ostomy support group to be particularly helpful in learning to learn this new way of life. Prior to discharge from the hospital, arrangements are also made for a home care nurse to come to the home after discharge to further assist the patient and their family for the first few days.

Most patients who are facing an operation during which a stoma is going to be required are filled with trepidation and concerns. In has been our universal experience that with the proper instructions every patient can learn what is necessary to care for themselves and with that they come to see that life with a stoma, although different, is still fully enjoyable.

Wound Management

Because of the type of surgery we do, our practice often has patients with significant open soft tissue wounds. These may either be on the abdominal wall or on the buttock and perianal area. These types of wounds often take a few weeks to heal and require some significant care both by medical personnel and the patient themselves. The Enterostomal Nurse is also a wound care specialist and has the expertise to guide the patient through this wound healing process. In the post operative period, once the bowel issues have been addressed by the patient’s surgeon, we will often ask the patient to see the wound care nurse to further guide the patient’s wound management. As the wound goes through the various stages of healing, she will advise changes in care resulting in swifter healing.

Some particularly large wounds are treated with a wound vacuum device which requires the dressing be changed every 3-4 days. This type of wound care is also available in our office through the nurses in our surgery center nurses.