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Ileostomy, construction of
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date of publication: 16.09.2012
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Stoma site marking
Ideally, the stoma should be marked and the subsequent instructions for stoma care given by specially trained stoma nurses or an experienced surgeon.
- Trial marking, with the patient supine or already sitting, within the right rectus abdominis (level of the umbilicus) in a 10×10cm skin area, preferably without folds and creases, scars and bony prominences.
- Check of the planned site with the patient in motion (standing, stooping down).
- The selected site should be easily accessible to the patient and within his/her visual field and away from the natural beltline.
- To allow for intraoperative complications marking a secondary location is recommended.
- Dressing the markings with sensitive skin bandages.
The site of the ileostomy deeply affects its management and thus the patient’s quality of life!
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Locating the loop of the terminal ileum
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Taping the ileum loop
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Skin incision for stoma and dissection down to the fascia.
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Dividing the anterior lamina of the rectus sheath
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Splitting the muscles
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Dividing the posterior lamina of the rectus sheath and the peritoneum
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Delivering the ileum through the abdominal wall
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Enterotomy and eversion of the proximal limb
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Suturing the ileum to the skin
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Stoma care