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Welcome to this video on stoma examination. Today, we'll cover the essential steps for examining a stoma including recognizing different types and assessing for complications. In this video. We'll begin with a brief overview of stomas, followed by the steps involved in the examination process. Jot down any questions that come up as you watch the video, we'll go over them together during our abdominal bedside teaching. So what's a stoma? It is a surgically created opening on the body surface connecting an internal organ to the outside. This provides a pathway for waste elimination. When the natural route like the colon or urinary tract is compromised due to disease or injury. There are several types of stomas commonly divided by anatomical location and purpose. Each serving different functions and involving different anatomical regions in terms of location. Some examples are colostomy, ileostomy and urostomy. A colostomy is created from the colon, usually in the left lower quadrant for sigmoid or descending colostomies and the ileostomy is created from the ileum, usually in the right lower quadrant. A urostomy is created to divert urine typically from the ureters or bladder using a segment of the intestine in terms of purpose and duration. Stomas can be permanent or temporary. Permanent stomas are intended to be long term. Often after removal of the lower gi tract, temporary stomas are used to divert waste while a section of the intestine heals commonly used in cases of trauma or following resection surgery. Let's move on to the steps involved in a stoma examination, examining a stoma might be new to many of you. Since it's a less familiar examination, it is normal to feel unsure about how it's assessed. The purpose of this video is to walk you through those steps, then practice together at the bedside. Hopefully, by then, you will feel more comfortable with this examination before examining a stoma, ensure the patient is comfortable and well prepared. Explain the procedure, gain consent and maintain a gentle approach, especially if the patient experiences discomfort or anxiety related to their stoma. There are two main steps involved in the stoma examination, general inspection of the patient and their surroundings followed by a closer examination of the stoma. Before we start examining, take a moment to inspect the patient's general condition. Are they in distress in pain or confused? Look around the bedside for medical equipment like catheters or IV lines, observing the surroundings can give you important context before diving into the exam. Now let's move on to the stoma itself. Ask if the patient is in pain or having trouble with their stoma prior to starting the step first, assess the site common stoma sites include the right, lower quadrant for ileostomies, left, lower quadrant for colostomies or the supra pubic area for urostomy. Remember this is a general rule. In some cases, these stomas are constructed in other locations. Next check the number of lumens. A stoma may be single lumen, double lumen or a double barrel depending on the surgical technique and purpose. One single lumen stoma or end stoma. It has a single opening where only one end of the intestine is brought to the abdominal surface. It's common in end colostomies or end ileostomies where the other portion of the intestine is either removed or closed off. Typically, it's permanent but can be temporary depending on the patient's needs. Two double lumen stoma or loop stoma consists of a loop of the intestine brought to the surface with two openings. One for waste elimination and one for mucus drainage. It is commonly created as a loop colostomy or loop ileostomy, often temporary allowing for downstream healing. Those are used frequently to divert stool in cases requiring temporary protection of distal bowel segments. Three double barreled stoma. This involves two separate stomas each connected to a different part of the intestine. One stoma serves as the functional opening for stool while the other is the distal nonfunctioning end. It is less common used in cases where a complete intestinal separation is necessary, determine if the stoma has a spout, spouted stomas have a protruding spout that extends from the skin surface which directs waste away from the skin. It is typically seen in ileostomies and urostomy. The spout prevents contact between the waste, often liquid or enzymatic and the skin reducing the risk of skin irritation or breakdown. Since the small intestine and urine contain more digestive enzymes and acids. A spout helps protect the skin from these substances. Flush or non spouted stomas lie flat or nearly flush with the skin surface without a spout. They are generally seen in colostomies, especially those in the descending or sigmoid colon. Typically used when the waist is more formed and less irritating to the skin, solid or semi formed stool from the large intestine is less damaging to the skin, making a spout less necessary. Next, observe the output type in ileostomies. Output is typically liquid. While colostomy output varies from soft to formed urostomy drain urine, evaluating the output consistency and volume can provide insights into stoma function and patient hydration. Moving on to the last step in our stoma examination, inspect the skin around the stoma carefully look for signs of erythema tissue breakdown or stoma prolapse. Check for any signs of ischemia which would require urgent attention surrounding skin issues are common in stoma patients and can significantly impact their quality of life. Can you think of any other complications to end the examination, cover the patient and thank them for their time. This concludes our video on stoma examination for further reading. You can refer to the A S CRS manual of colon and rectal surgery. See you next time.