This topic is about a patient who recently underwent the first step of a J-pouch surgery, which is a procedure often used to treat ulcerative colitis. The surgery involved removing part of the colon and creating an ileostomy, while leaving the rectal stump in place. The surgeon intentionally left an abdominal incision open to allow drainage, which has raised some questions and concerns for the patient.

Here are some key points and advice related to this situation:

1. The open abdominal incision was planned by the surgeon to allow drainage from the rectal stump, which is stapled internally. This is to prevent internal abscesses.

2. It is not unusual for blood, mucus, and even fragments of medication like Canasa suppositories to drain from the wound. However, if there are concerns about the amount or type of drainage, it is important to consult with a healthcare professional.

3. Healing of an open surgical wound can take time and may require frequent dressing changes. The use of special dressings, like silicone-wafer sponges, can help manage the wound.

4. If there is significant bleeding, pain, or signs of infection such as pus, odor, or fever, it is crucial to seek medical attention immediately.

5. Keeping the wound clean is essential. Use sterile dressings and change them regularly, ideally every 24 hours, until a wound-care specialist can be consulted.

6. If traveling to the original surgeon is challenging, consider getting a referral to a local wound-care nurse or specialist. Many hospitals have dedicated wound-care services.

7. Antibiotics like Flagyl and Amoxicillin are often prescribed after surgery to prevent infection. It is important to discuss any medication use with the surgeon before starting.

8. Pain in the rectal stump can be alleviated with warm sitz baths, which can be continued unless advised otherwise by a healthcare provider.

9. Understanding the surgical plan and expected outcomes, such as drainage, can help reduce anxiety. Patients on long-term prednisone may require a multi-step surgical approach, which is part of the treatment plan.

10. If there are any doubts or concerns about the surgical procedure or recovery, seeking a second opinion from another surgeon can provide additional reassurance.