What a stoma is and how it works
The word “stoma” means an opening. In medical terms, it refers to a surgically created opening on the abdomen.
During the operation, part of the intestine or urinary system is brought to the surface of the skin. Waste then leaves the body through this opening and is collected in a pouch worn externally.
A stoma is usually round or oval in shape. It appears red, moist, and slightly raised, and its surface is similar to the inside of the mouth. This is because it is formed from the lining of the bowel.
How the type of surgery can influence healing
Stoma surgery can be performed using different techniques. The approach used will depend on your individual situation and what your surgeon considers to be the safest and most effective option.
Open surgery (laparotomy)
In some cases, surgery is carried out as an open procedure, known as a laparotomy.
This involves making a longer incision in the abdomen to allow direct access to organs such as the bowel or bladder. This approach is often used in acute or life-threatening situations, where quick and effective access is required.
After a laparotomy, you will usually have one larger surgical wound, and sometimes two. These wounds are treated professionally in hospital immediately after the operation.
Once you return home, your stoma care nurse may continue to monitor and support your wound healing, if this is part of your care plan and prescribed by your doctor.
Keyhole surgery (laparoscopy)
In other situations, surgery may be carried out using a laparoscopic, or minimally invasive, technique.
This method involves making several small incisions in the abdomen. Through these openings, the surgeon inserts a small camera and fine instruments to access the bowel or bladder.
Planned procedures, including many stoma surgeries, are now commonly performed in this way.
One of the main advantages of laparoscopic surgery is that it avoids large abdominal incisions.
As a result, it is often associated with:
- less blod loss
- reduced pain and discomfort after surgery
- less strain on surrounding tissue
Because the instruments are smaller and more precise, there is generally less tissue damage. This can support healing and may make the recovery process feel easier.
Even though this technique is less invasive, wounds are still created. However, these are usually smaller and tend to heal more quickly than those from open surgery.
Understanding your skin and its role
Your skin plays an essential role in protecting your body. It acts as a barrier against external influences, helps regulate temperature, and allows you to feel sensations such as touch and pressure.
It can also reflect what is happening inside your body. Changes in health, diet or stress can sometimes show on the skin.
The skin is made up of three layers:
- Epidermis – the outer layer, providing protection
- Dermis – where blood vessels, nerves and glands are found
- Subcutis – the deeper layer, offering cushioning and insulation
These layers work together to keep your skin strong, flexible and able to repair itself.
Why the peristomal skin needs special care
The skin around your stoma is exposed to different types of stress every day.
This includes:
- pressure from the adhesive baseplate
- moisture from the pouching system
- contact with stool or urine
Because of this, the peristomal skin can be more vulnerable than other areas of the body.
If the skin becomes damaged, it can lead to discomfort, leakage, and difficulties with keeping the pouch securely in place. Maintaining healthy skin in this area is therefore an important part of your stoma care routine.
A stoma is not a wound
It’s a common misconception that a stoma is a wound.
The surgical wound is the incision made in the abdomen during the operation, and this will heal over time. The stoma itself is not a wound. It is formed from the lining of the bowel and behaves more like a mucous membrane, similar to the inside of your mouth.
Looking after the skin around your stoma
Caring for the peristomal skin is a key part of everyday stoma care. A consistent and gentle routine can help keep the skin healthy and comfortable.
Gentle cleaning
Each time you change your appliance, clean the skin around your stoma using lukewarm water and a soft cloth.
In most cases, water alone is enough. Soaps and cleansers are usually not necessary and may irritate the skin.
If you do choose to use a cleansing product, it should be:
- pH-neutral
- fragrance-free
- free from moisturising substances
This helps protect the skin and ensures the pouch adheres properly.
Drying the skin thoroughly
After cleaning, gently pat the skin dry.
Avoid rubbing the area, as this can cause small, invisible injuries to the skin. Before applying a new pouch or treatment, the skin should be completely dry to support proper adhesion.
Checking the skin regularly
Each time you change your pouch, take a moment to observe the skin around your stoma.
Look for signs such as:
- redness
- oozing
- swelling
- sores
If changes are noticed early, many skin problems can be managed effectively or even prevented.
Ongoing skin care after healing
Even after your body has healed from surgery, caring for your skin remains important.
Environmental factors such as cold weather or indoor heating can affect the skin and lead to dryness. While the baseplate provides some protection, regular skin care and observation are still needed.
Products developed specifically for stoma care can help protect and soothe the skin. Standard creams or lotions should be avoided, as they may irritate the skin or interfere with how well the pouch adheres.
When the skin becomes irritated
Despite careful care, the peristomal skin can sometimes become irritated.
Possible causes include:
- leakage from the pouch
- moisture trapped beneath the adhesive
- mechanical stress from repeated removal and application
If a fungal infection is suspected, it is important to seek medical advice. A healthcare professional may take a sample and recommend appropriate treatment, often using an antifungal solution.
Maintaining good hygiene and ensuring a well-fitting pouch are key steps in preventing further irritation.
Supporting the skin’s natural healing
Some products are designed to support the skin’s natural barrier and recovery.
For example, alginates can help absorb moisture and assist the skin in healing. These products may be used when the skin is sensitive or requires additional support.
Feeling comfortable in your everyday life
Looking after your stoma and your skin is not only about routine — it’s about how you feel in your body each day.
With the right care, the right products and the right support, it becomes easier to maintain healthy skin and a secure pouch fit.
Over time, these small daily steps can help you feel more comfortable, more confident and more at ease in your everyday life.