What are the postoperative care measures for rectal cancer

After rectal cancer patients undergo colostomy, irregular bowel movements are common in the early stages. Patients have no control over bowel movements, which brings many inconveniences to their lives and puts their bodies and minds under great test. However, after careful care of the artificial anus and with the patient's active cooperation in exercises, bowel movements will gradually become controllable. So what are the postoperative care measures for rectal cancer?

1. Pay attention to protecting the skin around the stoma. The skin around the stoma is easily irritated and corroded by feces and digestive fluid, which can easily cause skin eczema and erosion. If you pay attention to it in the early stage, it can be avoided. Pay attention to keeping the skin around the stoma clean and dry, wash it with warm water every day, and keep it clean and hygienic. Apply vaseline gauze or zinc oxide ointment around the stoma, wipe it with clean water after each bowel movement, and then replace it to prevent inflammation of the skin around the stoma.

In the early postoperative period, it is advisable to sleep in the left side position to avoid infection caused by feces contaminating the wound. If skin eczema has occurred, it can be washed with clean water to keep the local area clean and dry. In case of local erosion, zinc oxide ointment can be applied for protection, or skin care cream can be used. At the same time, the cause of excessive thinning of the embassy should be found. If it is diarrhea, antidiarrheal drugs should be taken orally.

2. Gradually develop the habit of regular bowel movements. If you have not had a bowel movement for a few days, you can take laxatives or go to the hospital for an artificial rectal enema. To train the awareness of regular bowel movements, you can use enema methods, twice a day, and then gradually reduce them to stimulate the artificial rectum and other intestinal mucosal reactions. Use 500-1000 ml of warm saline for irrigation each time. Before being discharged from the hospital, the patient can learn from the attending doctor and nurse, gradually learn to do self-irrigation, and pay attention to not using too much force when inserting the enema into the intestinal tube to prevent intestinal perforation. Patients can carefully experience it, find out the defecation rules, and develop the habit of regular bowel movements.

3. Some patients have colostomy stenosis due to scar contracture after surgery, so the stoma should be enlarged as appropriate after surgery. Use your fingers to expand the artificial anus every day to stimulate the sensitivity of the artificial anus mucosa, and also to prevent the artificial anus from shrinking and becoming narrow during healing, causing obstruction again. The method is: use the index finger to slowly push into the stoma after applying lubricant and stay inside for five minutes. The operation should be slow and avoid roughness. If the stenosis is severe and normal defecation is impossible, medical examination and surgical treatment are required.

4. Avoid actions that increase intra-abdominal pressure. If you have difficulty defecating, seek medical help to avoid intestinal mucosal prolapse or increased abdominal pressure that may cause intestinal hernia. You should properly control your range of motion, keep your emotions stable, and exercise and bend over appropriately to avoid excessive increase in abdominal pressure. Wear a belt when standing. If the prolapsed intestine is incarcerated, the intestinal wall is edematous, or even congested and necrotic, you should seek medical treatment in a timely manner.

5. Observe the blood supply to the stoma. Normal mucosa should be rosy and shiny. If it is purple or black, it indicates blood circulation disorder. Pay attention to observe whether there are any abnormalities in the color, smell, taste and amount of excrement. Seek medical attention at any time if you feel any discomfort.

6. Since the stoma has no normal sphincter and basically loses the function of controlling feces, stoma bags are often used clinically to prevent feces from overflowing. The colostomy opening is generally 1 to 2 cm above the skin surface, which is convenient for wearing a stoma bag and storing feces. Before using an artificial anus bag, clean the stoma and the surrounding skin and absorb moisture with soft paper.

Align the round opening of the stoma bag with the stoma, measure the approximate inner diameter, and simply adjust the inner opening to fit the skin around the stoma, close the clip, and buckle the belts on both sides. When the feces exceeds 1/3 of the bag, the stoma bag needs to be cleaned and replaced with a new one. Improper use of the stoma bag can cause friction, bleeding, infection, feces overflowing and contaminating clothes and producing odor. Therefore, two or more stoma bags should be prepared and used alternately, or disposable stoma bags should be selected.

7. It is very important to keep the stool sticky and formed. According to the doctor's instructions, use drugs that inhibit intestinal peristalsis, such as loperamide, camphor tincture, etc., to prolong the retention time of intestinal contents and increase the absorption of water and electrolytes to control the number of bowel movements. If diarrhea caused by intestinal inflammation occurs, oral antibiotics can be taken.