運用造口貼袋改善一位結腸癌病人傷造口潮溼性皮膚炎與惡臭之經驗

Experience of Using the Application of Stoma Bag to Improve One Colon Ostmate's Peristomal Skin of Moisture-Associated Dermatitis and Odor Problems

吳美鳳(Mei-Feng Wu) ； 王虹(Hung Wang)

《安寧療護雜誌》 25卷2期 (2021/03) Pp. 173-187

https://doi.org/10.6537/TJHPC.202103_25(2).06

摘要

臨床中面對病人傷口造口大量異味滲液，若無法有效控管，易導致潮溼性相關皮膚損傷，不僅護理人員疲於奔命更換傷口、造口敷料，同時也影響病人的生活品質，讓醫護人員倍感挑戰。本文描述一位結腸癌末期病人，複雜性傷口與空腸排泄造口大量臭味滲液，造成腹部皮膚廣泛性糜爛，同時遭受傷口及空腸排泄造口困難貼袋，住院過程護、病皆心力交瘁。筆者經由跨團隊討論，統整國內外文獻及臨床經驗，掌握敷料與造口袋特色，採取漢堡式堆疊貼袋技巧，改變傳統傷口、造口護理模式，有效收集傷口、造口滲液，控管惡臭味，進而恢復其皮膚完整性，提升護理品質與病人生活品質，最終讓亡者無憾，生者無怨。

關鍵字

結腸癌 ； 潮溼性相關皮膚損傷 ； 腸造口 ； 惡臭 ； 傷口照護

並列摘要

In the clinic, if we cannot effectively control a large amount of peculiar odor exudate from the wound of the patient's stoma, it will lead to moisture-associated skin damage (MASD) easily. Once skin damage occurs, the nursing staff must be exhausted to change the wound and stoma dressing, also reduce the quality of life of patients, so it does make the medical staff felt challenging. This article describes one advanced colon cancer patient who had complicated wounds and a large amount of odorous exudate from the jejunum excretion stoma, which caused extensive erosion of the abdominal skin. At the same time, she suffered from the difficult ostomy bag change to the wound and jejunum excretion stoma, medical staff and patients were exhausted during the hospitalization. The author through inter-professional collaborative discussion, the integrated domestic and foreign literatures, and clinical experiences to master the characteristics of dressings and ostomy bags in adopting the Hamburg- stacking patch ostomy bag technique, changed the traditional wound and stoma care model, effectively collected wounds and stoma exudate, also reduced malodor, and then recovered the integrity of the skin. Improving the quality of care and the quality of life of patients, thus the dying patient, families and friends will have no regrets.

並列關鍵字

colon cancer ； moisture-associated skin damage(MASD) ； stoma ； malodor ； wound care

參考文獻

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