It is very important to cover the stoma at all times in order to prevent dirt, dust, smoke,
bugs, etc., from getting into the trachea and lungs.
There are various kinds of stoma covers. The most effective ones are called Heat/Moisture Exchangers (HME) because they create a tight seal around the stoma. In addition to filtering dirt, HMEs preserve some of the moisture and heat inside the respiratory tract and prevent the person from losing them. The HME therefore assist in restoring the temperature, moisture and cleanliness of the inhaled air to the condition before the laryngectomy.
The stoma often shrinks during the first weeks or months after it is created. To prevent it from closing completely, a tracheostomy or laryngectomy tube is initially left in the stoma 24 hours a day. Over times this duration is gradually reduced. It is often left overnight until there is no more shrinking.
Those with inadequate stoma ( too small, too large or deformed) may benefit from surgical repair (stomaplasty).
Stoma care when using a base plate or adhesive housing: The skin around the stoma can become irritated (i.e.,red, inflamed) because of repeated gluing and removal of the housing. The materials used to remove the old housing and prepare for the new one can irritate the skin. The removal of the old housing can also irritate the skin especially when it is glued.
An adhesive removal wipe containing liquid (e.g. Remove TM, Smith & Nephew, Inc. Largo Fl 33773) can assist in removing the base plate or housing. It is placed at the edge of the housing and helps the housing detach from the skin when it is lifted off. Wiping the area with Remove TM cleans the site from remnants of seal used to glue the housing. It is important to wipe off the leftover Remove TM with an alcohol wipe so that it will not irritate the skin. When a new housing is use, wiping off the Remove TM prevents it from interfering with placing glue again.
If the area appears red, tender or smells bad, stoma cleaning should be performed more frequently. Contacting one's physician is advisable if a rash, unusual odor, and/or yellowish-green drainage appear around the stoma. This may represent a bacterial infection.
Do and and don't in stoma care:
- Keep the stoma clean: Keep the inside of the stoma clean, moist, and glistening. Saline "bullets" can help keeping it moist.
- Keep the tracheostomy tube clean; If you wear a tube follow your physicians and nurses direction for its care.
- Cover stoma at all times: Use an heat and moisture exchanger, gauze, cotton, or crocheted covers.
- Exercise with moderation: Excessive whenever you can but without too much strain.
- Dress comfortably: Allow for circulation of air, coughing and protection of clothing from coughing and secretions.
- Cover stoma when coughing or sneezing: Use thick paper tissues or handkerchiefs to pick up any coughed mucus.
- Wear identification: Carry medical identification. It is available from the American Cancer Society, Medic Alert and or your physician.
- Have regular medical examinations: Have regular examinations with your primary and ear nose and throat physicians.
- Do not allow water to enter your stoma: Do not swim unless you use a Larchel snorkel, which helps protect your airway. Use care in bathing, shaving. Use a shower shield or a moist towel to cover your stoma.
- Do not inhale smoke, dirt, dust or irritating fumes: Avoid inhaling smoke, dust or irritating fumes and use stoma covers to protect you.
Protecting the stoma from water when showering
It is important to prevent water from entering the stoma when taking a shower. A small amount of water in the trachea generally does not cause any harm and can be rapidly coughed out. However, inhalation of a large amount of water can be dangerous.
Methods to prevent water from entering the stoma are: