Daily stoma care is important to maintain a healthy tracheostomy site and to prevent the skin from becoming irritated. One source states that the skin around the stoma should be cleaned at least twice a day to prevent irritation and infection. However, a discussion with your pediatrician will determine the best care for your child. Some children may have more secretions than others and it can even depend on the day. This will determine how often the stoma needs to be cleaned. According to Johns Hopkins Medicine, if the area appears red, tender, or smells badly, stoma cleaning should be performed more frequently.
Here is a basic, step-by-step guide to proper stoma care:
Equipment:
· Face cloth (soft wash cloth)
· Cotton-tipped applicators
· Hydrogen peroxide (1/2 strength- equal parts peroxide and water) or whatever cleaning solution your pediatrician recommends
· Normal saline
· 2x2 dressing
Steps:
1. Wash your hands.
2. Remove any dressing around the tracheostomy. The tube should not have to be removed to clean the stoma.
3. Dip the cotton applicators in the cleaning solution (hydrogen peroxide). Normal saline can be used if the peroxide is too irritating. Use the cotton applicators to clean around the site. Start as close as possible to the tracheostomy tube and then work away from it. (see video demonstration)
4. Repeat the process until the debris or mucus is removed. (see video demonstration)
5. Use dry cotton tip applicator or face cloth to dry skin.
6. Gauze may be placed under the trach tube as recommended by physician. A dry dressing can be helpful if the skin appears reddened or irritated.
**According to one study, using barrier cream under the gauze following cleaning provided the best skin care results.
Here is a great video depicting proper stoma care:
Here is a basic, step-by-step guide to proper stoma care:
Equipment:
· Face cloth (soft wash cloth)
· Cotton-tipped applicators
· Hydrogen peroxide (1/2 strength- equal parts peroxide and water) or whatever cleaning solution your pediatrician recommends
· Normal saline
· 2x2 dressing
Steps:
1. Wash your hands.
2. Remove any dressing around the tracheostomy. The tube should not have to be removed to clean the stoma.
3. Dip the cotton applicators in the cleaning solution (hydrogen peroxide). Normal saline can be used if the peroxide is too irritating. Use the cotton applicators to clean around the site. Start as close as possible to the tracheostomy tube and then work away from it. (see video demonstration)
4. Repeat the process until the debris or mucus is removed. (see video demonstration)
5. Use dry cotton tip applicator or face cloth to dry skin.
6. Gauze may be placed under the trach tube as recommended by physician. A dry dressing can be helpful if the skin appears reddened or irritated.
**According to one study, using barrier cream under the gauze following cleaning provided the best skin care results.
Here is a great video depicting proper stoma care:
References:
https://www.youtube.com/watch?v=d2wSiWuTxoc
http://web.b.ebscohost.com.byui.idm.oclc.org/ehost/detail/detail?vid=3&sid=0222a308-95e6-4a17-b5ac-e4ec00ebc5a8%40sessionmgr112&hid=105&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=cmedm&AN=24202220
http://www.hopkinsmedicine.org/tracheostomy/living/stoma.html