This topic is about someone who has been living with a stoma since 2011 and is now facing the possibility of a fourth ostomy surgery. Over the past year, they have experienced several complications, including multiple hernias, an abdominal fistula, and an abscess that required drainage. After a lengthy hospital stay, they were diagnosed with malnutrition and started on total parenteral nutrition (TPN). The surgical team is suggesting the removal of the remaining colon and rectum, which is a significant and life-changing procedure. The person is understandably confused and distressed, especially since their latest colonoscopy was clear. They are seeking advice and experiences from others who might have faced similar situations.

Here are some helpful pieces of advice and insights:

1. Ask your surgical team for a thorough explanation of your current diagnosis, the reasons for the proposed removal of the colon and rectum, and any alternative options that might be available.

2. Consider getting a second medical opinion before agreeing to any major surgery that could significantly alter your life.

3. Make sure to understand why malnutrition has occurred and whether it is related to the fistula, abscess, or other gastrointestinal issues.

4. To reduce the risk of infection before surgery, consider using Hibiclens antiseptic soap (a teal bottle containing chlorhexidine gluconate cleanser) to wash the surgical area, as it is widely used by surgeons.

5. If you are dealing with abscesses or infected wounds, silver-impregnated gauze dressings might be helpful in controlling bacterial growth and promoting healing.