Download Intestinal Stomas: Principles: Techniques, and Management, by Peter Cataldo, John M. MacKeigan PDF

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By Peter Cataldo, John M. MacKeigan

This article gains insurance of easy intestinal body structure, in addition to the administration of issues and weird difficulties. extra chapters and completely up to date fabric examine laparoscopic-assisted colostomy and strategies of urinary diversion in stoma administration.

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This system allows for easy stoma access since the pouches can be removed and the faceplate can be left intact. In addition, the pouches can be washed and reused. CONCLUSION Over the past 200 years intestinal stomas have developed from “last chance,” lifesaving efforts to well-planned, technically refined artificial anuses. Colostomies can be “trained” to function once every 24 to 48 hr. Ileostomies and urostomies can be made “continent” if the patient so desires. Although stomas formerly were foul-smelling and offensive, today they are rarely noticeable, even to the patient’s closest contacts.

Poor weight gain and episodes of dehydration cease once the loop ileostomy is closed. Total body potassium depletion is rare in a patient with an uncomplicated ileostomy. Normal individuals and ileostomy patients lose about 9 mEq K + each day, regardless of the magnitude of the output of feces or 44 Taylor and Pemberton ileostomy effluent [23,24]. A chronic state of salt depletion causes ileal potassium secretion to increase in exchange for maximizing ileal sodium absorption. Excess potassium and total-body nitrogen losses reflect extensive small bowel resection.

CONVENTIONAL ILEOSTOMY Ileostomy Output There appear to be three distinct phases of adaptation during the initial postoperative period following stoma construction. Ileostomy effluent during the first 1–3 days is bilious and liquid in nature, and each day the output increases. During the second phase, beginning between days 3 and 5, the output stabilizes or decreases slightly. The third phase is characterized by steadily declining outputs until a steady state is reached 6–8 weeks postoperatively [1].

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