Basic Stoma Care
Patients who are submitted to a complete larynx removal (laryngectomy) will have a surgically formed hole in the front region of their neck to help them breathe normally. This is called a stoma and is very important for the patients to be advised by a doctor or a nurse on how to correctly take care of it, due to its high risk of infection and breathing problems.
Observation of the area around the stoma and inside the wall of the trachea needs to be done in the search for mucus and crusts that may have formed throughout the day or night. Is important to make this a regular routine by watching these areas in front of a mirror every morning and evening.
In case of mucus or crusts presence, sometimes, these are simply removed by coughing them out. Using a saline spray or applying a warm, damp cloth over the stoma can also reduce the presence of these elements in it. Running hot water in a sink, leaning over, and inhaling the steam through the stoma is pleasant, but is necessary to protect it with a washcloth or shower shield.
The stoma needs to be always clean. For this, gently washing the skin around its opening with mild soap and water, and dry wiping it. If the stoma is kept clean and free from secretions, the around it will not become dry or irritated.
Covering the stoma helps keep it clean and healthy by preventing dust, bugs, cold winter air, hot dry air, and other harmful particles from entering the airways. It is also capable of retaining the warmth in the air of your breathe and protect the skin from sun rays. Many covering options include special stoma covers, crocheted bibs, scarves, turtlenecks, cotton U-neck undershirts or even jewelry.
The use of an electrolarynx device directly on the stoma should be avoided. While the chance of it causing irritation is minimal, the stoma is not the ideal spot to press your speech aid at. More information on how to find your “sweet spot” here.
Showering and bathing can add important extra humidity for the stoma. However, the patient would have to prevent excess soap and water from entering into it. Patients usually use chest high shower sprays or hoses, stoma shields, damp-dry cloths, etc. to protect the stoma while showering. Some people also cup their hand over their stoma, giving their back to the showerhead. Is important to continue having a normal washing routine to keep proper personal hygiene.
Shaving is another delicate topic for laryngectomy patients. They need to be careful not to get soap in their stoma. In addition, limiting the use of aerosol sprays or deodorant sprays can eliminate the irritation of the airways. Is important to remember that the neck may be numb for a few months after surgery in order to not accidentally hurt it without knowing it.