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Jul 01, 2014

Recovery from Reversal Surgery - Wound Care Experiences?

This topic is about the experiences and advice related to the healing process after ileostomy reversal surgery, specifically focusing on the care of the former stoma site. After such surgery, it's common for the surgeon to leave the wound open to heal from the inside out, which involves regular packing and dressing changes. Here are some insights and advice shared by others who have gone through similar experiences:

1. It's normal to feel a severe sting or burning sensation during the early stages of packing. This is often due to the antiseptic or cleanser used, but the discomfort usually decreases as the wound begins to heal.

2. The typical healing process involves the wound filling with granulation tissue, which eventually reaches the surface. Then, the skin grows inward from the edges until the wound closes. For a wound about 6 cm long, 3 cm wide, and 3-4 cm deep, healing might take around six weeks.

3. Be aware of signs of infection, such as a foul odor that is different from normal wound exudate and persistent pain that isn't just related to the dressing changes.

4. Increasing your protein intake with foods like meat, eggs, dairy, or protein shakes can help speed up the healing process by supporting tissue growth.

5. Rest and limiting physical activity are important to allow the tissue to heal properly. Over-exertion can cause new tissue to tear and lead to bleeding.

6. If the skin around the wound is irritated by leakage or drainage, using a "crusting" technique with stoma powder and a liquid skin protectant can help protect it.

7. Local anesthetics are not typically used for packing, but you might consider taking oral pain relief 30-45 minutes before the procedure. Consult with your nurse or doctor about suitable options like acetaminophen, NSAIDs, or prescribed opioids.

8. Puckered edges are often just a sign of contracting granulation tissue. However, if you notice sudden changes in color, heat, swelling, increased drainage, or odor, contact your nurse or doctor immediately.

9. Healing times can vary based on the size of the wound, your overall health, and how long the stoma was in place. Generally, it can take 4-8 weeks for moderate-to-large wounds to heal.

10. Emotional support is crucial. Family and friends might not fully understand the ongoing pain, so reaching out to online forums or stoma nurses can provide much-needed understanding and support.

11. For those considering reversal surgery in the future, surgeons often wait 3-6 months before reconnecting to allow for internal healing. The longer a stoma is in place, the more complex the reversal can be, with a higher chance of prolonged bowel dysfunction.

12. Long-term outcomes can vary significantly. Some people regain normal bowel control, while others may experience chronic pain or require a permanent ostomy. It's important to discuss all potential risks with your surgeon.
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