Wound and Ostomy

Wound, Ostomy, and Continence Nursing is a specialized field of nursing involving the care of patients with stomas, incontinence, pressure injuries, and other select skin conditions or those needing wound care. Wound and ostomy nurses provide acute and rehabilitative care to children with disorders of the gastrointestinal, genitourinary and integumentary systems that require the surgical creation of an ostomy (stoma). One of the primary goals of wound and ostomy nursing is to facilitate a child’s transition from the hospital to the home. The wound and ostomy nurse provides children and their families with the education necessary for independent care at home, as well as education to prevent and treat certain stomal complications and skin problems.

Referral Requirements

Referrals are required from primary care physicians or other Children’s Hospital specialty services. Referrals for patients enrolled in managed care insurance plans also may require authorization from the insurance provider and primary care physician. All necessary referral and authorization forms must be received before the patient’s visit. For accurate provider numbers or more information, please call the office number listed.

Pediatric Ostomy Resources

What to expect before ostomy surgery:

Once it is determined that you need, or may need, an ostomy, you will meet with a surgeon that performs this type of surgery. During your appointment, the surgeon will explain the procedure and be able to discuss any concerns that you have regarding your upcoming surgery. You will have the opportunity to ask any questions and make sure you fully understand the procedure. If it is required by your surgeon, the day before the ostomy surgery you will need to follow your bowel preparation instructions. You also will not be able to eat or drink anything overnight before surgery. The surgeon will instruct you on your exact requirements.

“Stoma Marking": (FYI- an ostomy may also be referred to as a “stoma”) Typically on the day of surgery, your ostomy nurse will examine your abdomen and place a marking in the best position for your ostomy. You may be asked some questions regarding what type of clothing you like to wear, activities you’re involved in, or where your pants’ waistband sits. Based on these answers, the ostomy nurse will choose a site where the skin is smooth, without creases, scars, or folds, to make placing the ostomy pouch as easy as possible. You will have to stand, bend forward, lay down, and sit up for the ostomy nurse to best examine your abdomen. This is also a great opportunity to get to know the ostomy nurse and ask any other ostomy care questions you may have.

On the day of your ostomy surgery, you may need to use special soap in the shower that cleans your skin before surgery. Then, the hospital staff will ask you to remove all loose accessories, nail polish, glasses/contacts, and jewelry and have you dress in a hospital gown. Finally, you will be transported to the preoperative area and will be prepared for your surgery.

What to expect after ostomy surgery:

After surgery, there will be a stoma on either the left or right side of your abdomen which will be contained in a pouching system. The pouch will be clear so that your doctors and nurses can monitor your ostomy—its color and the stool output that comes out of the ostomy. You will have stitches around the edges of the stoma on your skin, and typically an incision or laparoscopic sites on your abdomen from the surgery. The size of the stoma can decrease over 6-8 weeks following the surgery. An anesthesiologist and your surgeon will have put together a plan to address any post-operative pain you may have.

About 2-3 days after surgery, you will have a teaching session with the ostomy nurse who will educate you on how to care for your ostomy—changing the pouching system, cleaning around it, and answering any questions you might have. You will have the opportunity to have multiple teaching sessions, if needed, and will be given the ostomy nurses’ contact information to use even when you leave the hospital. If you need extra help learning how to change your pouch, changing the type of ostomy pouch you’re using, or are having any skin issues, the ostomy nurse will be there to help.

When can I leave the hospital after ostomy surgery?

This will differ depending on the type of surgery you had, the amount of time it takes for your ostomy output to become normal, pain control, and how well you are eating and drinking. It is also essential that you or your family member(s) know how to take care of the ostomy and can show independence in your ostomy care before leaving the hospital.

Other helpful resources:

For all other questions regarding ostomies, pouching systems, or troubleshooting pouching issues or skin problems, please contact the ostomy nurse.