In this article, we will discuss Brief Note on Ileostomy. So, let’s get started.
Ileostomy
It is the formation of an artificial opening in the small bowel left or right to divert the feces to the exterior where they are collected in a disposable, adhesive plastic bag. It could be temporary or permanent.
Incision used are right para median incision/more or less on Mcburney’s point. No drain functioning on 2–4 days.
Operations on Large Intestine
• Caecostomy
• Colostomy
• Terminal colostomy
• Loop colostomy/transverse
• Defunctioning colostomy
• Colectomy-right & left hemi colectomy
Causes
• Carcinoma, TB, Crohn’s disease, Meckel’s diverticulum & ulcerative colitis
• Incision used – Right/left PM incision
• Abdominal & pelvic drains – 5th day removal
Physiotherapy
• As per protocol
• Follow day wise/session wise progression
• Do routine preop & postop assessment and training
• Change the treatment plan & execution of exercises according to the need
• Safety and don’ts are more valuable than do’s
• Start exercises to the parts away from the incision site
Common preop training and Postoperative assessment
Problems
• Increased production of mucus secretions
• Inhibited cough reflex due to pain & Ryle’s tube
• Tiredeness – Anaemia – less RBC production
• Haemetemesis
• Deep vein thrombosis (DVT)
• Other complications of abdominal surgery
Treatment
• Chest physiotherapy – Postural drainage, positioning, humidification
• Encourage cough reflex/cough support
• Treat for short duration (20-30 min)
• Arm/leg exercises, bed elevation
• Early mobilization-prop up in the evening or next day/bed mobility
• Wound care-Hygiene
• Micturition /bowel care& training
• Pain relief – TENS
• Oral hygiene
• Diet management
• Abdominal & trunk exercises after 1-2 days in a progressive manner
• Discharge depends on surgery may be 3- 4 days to 10-14 days/minor or major surgery with or without complications