Shindo K
First Dept. of Surgery, Kinki University School of Medicine.
Gan To Kagaku Ryoho. 1990 Apr;17(4 Pt 2):813-8.
Colostomy devices are classified as follows: One-piece and two-piece by structure; Closed, open-end or straight, open-top, drainable, and mini by pouch function. The one-piece device is simple and convenient (disposable) but not cheap; The two-piece one has various exchangeable pouches but some skill is necessary for fitting a pouch to the flange. A closed pouch is disposal en bloc, while an open pouch allows a hand to be inserted several times. The drainable pouch is useful for draining faeces easily with water, while a mini-pouch is unobtrusive and attractive. The skin barrier has been used frequently as a part of the device. Its contents are hydrophilic colloid, hydrophobic colloid and agglutinant. The barrier functioning is dependent on content-ratio and on structure. The latter is classified as blend, laminate, swiss-roll, polka-dot, and froth in type. The apparatus must be used for individual colostomy, utilizing the characteristics based on its specificity; an open-type one-piece unit is used with skin barrier for a postoperative colostomy in the first week, a drainable-type, two-piece unit for another week following suture removal or for diarrhea, and a closed type for rehabilitation. This procedure is called a pouch total system. The irrigation method is good for a scheduled defecation and for peri-stomal dermatitis and for a deformed stoma, but takes more than a half hour and needs a special toilet for irrigation. Indication of the method is for a young ostomate, a sportsman, a field worker, a neurotic or myosophobic person and so on. Today a pouch-free natural defecation method is becoming popular; a kind of stopper is used for a colostomy. This is a foam plug which expands to block feces and eliminates noise and odor. The method is good for pouch-free living, but fecal leakage is encountered in diarrhea.
按结构分为一体式和两件式;按造口袋功能分为封闭式、开口端或直管式、开口顶部式、可排空式和迷你式。一体式装置简单方便(一次性使用)但价格不菲;两件式装置有各种可更换的造口袋,但将造口袋安装到法兰盘上需要一定技巧。封闭式造口袋是整体处理,而开口式造口袋允许多次伸手进去。可排空式造口袋便于用水轻松排出粪便,而迷你式造口袋不显眼且美观。皮肤屏障经常作为装置的一部分使用。其成分包括亲水性胶体、疏水性胶体和黏合剂。屏障功能取决于成分比例和结构。后者在类型上分为混合式、层压式、瑞士卷式、圆点式和泡沫式。该装置必须根据其特殊性,针对个体结肠造口术使用;术后第一周,开放式一体式装置搭配皮肤屏障用于结肠造口;拆线后一周或腹泻时,使用可排空式两件式装置;康复期使用封闭式装置。这个过程称为造口袋全系统。灌洗法有利于定时排便、预防造口周围皮炎和处理变形造口,但需要半个多小时,且需要特殊的灌洗马桶。该方法适用于年轻的造口者、运动员、野外工作者、神经质或怕脏的人等。如今,一种无袋自然排便法正变得流行;一种塞子用于结肠造口。这是一种泡沫塞,膨胀后可阻挡粪便,消除噪音和异味。该方法有利于无袋生活,但腹泻时会出现粪便泄漏。