How to care for small intestinal fistula placement

Patients who undergo intestinal incision and stoma placement must pay attention to and take correct care of themselves in their daily lives after the operation. After the operation, patients must pay attention to avoid vomiting and suffocation caused by inhalation. They must clean up the secretions in a timely manner and use the stoma bag under the guidance of a doctor and master the care skills.

1 General care

After the operation, the patient should lie flat without a pillow, with the head tilted to one side to avoid choking by aspiration of vomitus, clear oral secretions in time, and keep the airway open. Newborns have poor temperature regulation function and are easily affected by the ambient temperature and develop hypothermia. Therefore, they should be placed in an incubator to keep warm, with the temperature maintained at 28-32°C to prevent the occurrence of scleredema. Take good care of your skin and keep your bed flat, clean and dry. Understand the type and location of fistula. If a gastrointestinal decompression tube is placed, keep the drainage tube unobstructed to avoid twisting, folding, and slipping of the drainage tube, and record the color, nature, and amount of the drainage fluid. Observe the blood circulation of the intestine to check for abnormal conditions such as bleeding and intestinal prolapse. If any abnormality is found, notify the doctor promptly for treatment. Early parenteral nutrition after enterostomy is the main supply route, especially since the fasting time after NEC is long. Planned protection of veins is particularly important, and deep venous catheterization or PICC can be used; maintain water and electrolyte balance, accurately record 24-hour urine volume, gastrointestinal decompression drainage volume and stoma output, and monitor changes in arterial blood gas. Use an infusion pump to pump intravenous nutrition solution at a constant speed for 24 hours. Provide good dietary care for children with intestinal fistula in the later stage: Newborns and infants generally start feeding in small amounts 2-7 days after surgery. During feeding, pay attention to whether the child tolerates the feeding, whether there is abdominal distension, vomiting, and the nature and color of the discharge from the fistula. If oral feeding is not tolerated, nasogastric feeding can be used first. Infants and children should be given a high-calorie, high-nutrition, low-residue, easily digestible diet with small and frequent meals, and appropriate temperatures. They should also be given Letuoyi to regulate intestinal flora and prevent diarrhea.

2 Discharge Instructions

Instruct the family members of the child to learn how to use the ostomy bag correctly, master nursing skills, and reduce complications; after the stitches of the surgical wound are removed and the wound is completely healed, the child can take a shower and can wear the ostomy bag while showering, or remove the ostomy bag without worrying about moisture entering the intestinal cavity through the stoma; instruct the family members on feeding precautions and add complementary foods appropriately; observe abdominal signs, the amount, nature and color of stool from the stoma, etc.; the child's clothes should be soft, comfortable and loose to avoid the belt tightening the ostomy bag.

3 Summary

Enterostomy is an important means to save lives and improve life, but if it is not properly cared for, various complications may occur and even endanger life. Nursing staff should work together with parents to minimize the discomfort of children, reduce the incidence of colostomy complications, and improve the quality of life of children.