In ostomy care, identifying stoma ischemia is most urgent when you observe which finding?

• A. Red, moist stoma
• B. Brown crust around stoma
• C. Gray or pale color of the stoma
• D. Slight swelling around stoma

Answer: (C)

Stoma perfusion is shown by its color. A healthy stoma is pink to red and moist, reflecting good blood flow. When the stoma appears gray or pale, it signals compromised blood supply and potential ischemia. That’s an urgent concern because without prompt restoration of circulation, tissue can become necrotic, risking stoma viability and skin integrity. Immediate assessment is needed to identify causes such as constriction, kinking, or external pressure and to involve the surgical team.

A red, moist stoma is normal and indicates good perfusion. Brown crust around the stoma is common as secretions dry. Slight swelling around the stoma can occur after surgery and is not an urgent sign of ischemia.