Dealing with Retracted Stoma and Mucocutaneous Separation

Hi all,

Almost a month out from my emergency surgery that resulted in my colostomy. Was in the hospital for two weeks after due to ileus and then abscess and the whole time no one said anything... the WOCN mentioned my stoma was retracted but after I finally got home I realized there is more to the problem.

It seems from the way the surgeon cut into my abdominal wall for the stoma that it was made just way too big. As such, I think I have what is called a "complete/deep mucocutaneous separation." My stoma is retracted below surface level but also sitting inside a crater of my mucocosa. So my output just fills the area and gets it irritated. It was infected when I first figured this mess out somewhat but since then I've been going through a bag a day, mostly just keeping the bag off so I can jump in the shower and clean out any waste immediately as it comes out.

Does anyone have any ideas to help the healing? I tried stoma powder but that messed me up and made the mucosa bleed a lot. Alignates are packed around the stoma but before long the output wrecks them. I can't put on a convex because of how retracted the stoma is into the mucocutaneous separation. At a loss here and going crazy constantly cleaning out this area. My home health nurse pretty much ignores the area because she said she has never seen anything like it before.

Thank you!

Hey there Farter..........I don't know what kind of doctors and nurses you have in your neck of the woods.........but that needs to be fixed ASAP. You're fooling around with a potentially dangerous infection that if it makes its way behind your abdominal wall you're f&*ked. Like life-threatening. From what you describe it doesn't really matter if you get the irritation under control, that's just the tip of the iceberg. You need to have that surgically corrected like yesterday! First thing I'd do, being it's a Saturday, is call your surgeon who made that mess....and their phone recording should give you the option of either calling whomever is covering for him/her or to go to the emergency room. Pick your poison. If you still like your surgeon, and I'm not sure I would if they did that to me, get in touch with them right away......or the person covering. Talk to someone! Be ready to send a pic of your mess via your phone to them. If you choose the emergency room route, which is always a crapshoot, at least around here.......pick a good one. Not sure what hospitals are near you, but do a few minutes worth of research and see what their colorectal docs are like online. Then go. If that infection spreads to your internal cavity you'll be hearing the word 'sepsis' quite a lot.......which is never a good thing. Don't take this lightly......sepsis can spread like wildfire, which being from CA I'm sure you know all about. Once it spreads it's very hard to control because once in your internal cavity it has access to everything. Which can make it impossible to control.......if you get my drift. Check your temperature now. If you have even a slight elevation in temp......you need to get your ass in gear as the clock is ticking......and fast. Don't worry about getting your home health nurse fired until AFTER you get this sorted out.

In all seriousness.........your problem isn't the irritation.......it's the infection. Get in front of it now or you may never. Sorry to sound so dire.........I had sepsis and it was NOT fun. Neither was all the crap I had to go through to get rid of it. You're talking about some really serious antibiotics......until they run out of things to try. So make the call or go to the ER and let someone with more knowledge than me check you out and figure out the best course of action. Don't sit there and wait........you're only making things worse.

;0)

Later,

bob

Forlorn

wow i am sorry to hear about your post-op course.  I can only recommend that you see a/ your surgeon quickly.  Sometimes in medicine quick intervention is better than waiting to see if the wound care products will help.  I have had Ileus 3 times since 4/2020.   In fact I am laying in bed after an 11 day hospital stay after a "small procedure" that resulted in an Ileus.  

if the home health agency does not have a WOCN check other area hospitals or wound care centers.   The home health agency get paid well for your care and if they are not doing it adequately I would look for another provider.   I know when I had HH all of the nurses were not comfortable with ostomy care but my nurse was their "expert" and offered sound advice and call the surgeons office with any questions.  

let us know how you are doing!

if you want to discuss Ileus or anything else just message me

Clint

Hi Bob,

Thank you for the information and concern. I have sent a photo to my surgeon the other day and he said there is nothing acute to be done. Just one area has a deeper pocket. Already on antibiotics as I was dealing with sepsis twice already when in the hospital.

Have an appointment with surgeon on Wednesday and just sent him a text letting him know about the part that is a deeper pocket as he might not have been able to tell from the photo I sent.

Thank you.

Hi, Clint,

Thanks for your response. The ileus cleared up in about a day or so. It happened right after my procedure.

I appreciate your input. Thank you.

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