Having issues with Packing of open midline incission very close to stoma

Nothing wrong with free balling. I also learned the term "going commando" on this site as well, after having to change my bag at work, far from home, and just left off the unders (was wearing a dress). Sometimes having little secrets at work was fun.
But for the packing, I don't know, and I think the best thing is to get the stoma nurse to come by, that's their turf. At least get on the phone with him/her, explain about the expanding incision, and they'll decide if they need to come have a look or just give you instructions on the phone.
In general, I'm really impressed with your progress!

Yup I would definitely check in with the WOCN... IDK how it works in your neck of the woods but the outpatient WOCN for my surgeon is always available and visits are FREE, I abuse that service to the fullest extent (always go see her at the first sign of skin irritation or any minor thing that might possibly be going on).

Probiotic- you are doing exactly as I did when my incision opened. Well until I ended up with an abscess and had to go back to surgery and have the incision cleaned out and REALLY opened into a huge wound (something like 13cm by 3cm) that needed a wound vac. That was due to very rare allergic reaction to the internal sutures used in my abdomen though.... definitely not a normal situation so I wouldn't worry about that.

Anyway... before that all went down, my open wound was a similar size to yours we did the same thing with the strip gauze moistened with saline then loosely packed into the wound and covered with dry gauze. I too had to offset my wafer. The only thing that saved me from leaks was my Eakin Ring. As long as that stayed in place (which miraculously it did even with all the moisture) I was okay. Sometimes the edge of my wafer along the wound would peel up so far that I could see the outer edge of my Eakin under there... but again... the Eakin always held firm and maintained a seal. I slept on my right side for months because I was so afraid if I laid on my left side, output might leak out and get into my wound. Never happened though.

Another thing I did was to take Coloplast strip paste and sort of build it up under the left edge of my wafer. It helped even things out since my wound formed a pit that was lower then the rest of my abdomen (hard to explain). Once the wound filled in as it healed, I no longer had to do this.

Good luck!

When in doubt with incision stuff... I would definitely ask the doctor or WOCN. My problematic incision did a little bit of everything... opening, tunneling, forming an abscess.

All was fine initially with my incision until two weeks post-op. I had just gotten the staples out of my midline incision (I did not have lapro) and then a couple days later the incision started to open the tiniest bit. I wasn't worried at first, but later that day clear pink liquid started to ooze out of it like crazy... probably about 1/4 cup in one hour. Of course, this happened on a weekend so I couldn't get in to see my surgeon. I called him and he gave me directions on how to pack it and said to come see him if it got worse. Over the next day or two the open section got longer and that pink liquid kept copiously coming out of it. Still, I really thought it was just the upper layer of skin. Turns out when I went in to see my surgeon after the weekend that the incision had opened all the way through the muscle wall and into my abdominal cavity (hence all that liquid coming out). Only an inch was open that deep fortunately, but it is a serious complication (especially if it would have opened even more) so I immediately went back to surgery and it was repaired. At this point my surgeon thought it was due to prednisone's effects on my tissue's ability to heal as the drug commonly causes poor healing.

At first the repaired incision was doing great, but within three weeks the upper layer started to open again (fortunately not the lower muscle layer this time). At that point I had to start packing mine with strip gauze like you are to get things to heal from the bottom up. As the weeks went on, things were healing well. Most of the incision had filled in and closed up except for this one little hole that was basically like a tunnel under the skin. We just couldn't get it to heal! My surgeon was actually pretty frustrated because things were healing beautifully with my butt incision (which is usually the problematic one) but that small tunnel into my abdominal incision just wouldn't close. I had been off of prednisone for well over a month at that point and it should not have been affecting my healing anymore. about 2.5 months after my initial surgery, I developed an abscess near the tunnel and we knew something was up. I went back to surgery a third time and my surgeon cleaned out he abscess and opened the whole upper layer of the incision to see if there were any clues to why this thing wouldn't heal. It was now apparent that all this had likely been caused by a reaction to the dissolvable sutures used in my abdominal wall... something my surgeon had never seen in all his years of surgery. The sutures he used were one of the least reactive and benign types out there but leave it to my body to do the rare thing. It also now made sense why my butt incision had healed so well... sutures made out of a different type of material had been used there.

He removed the offending sutures in my abdominal wall and replaced them with some made out of a different material. However, by this point the wound had to be healed completely open. It was hard to look at. I could sit my entire hand flat in my wound and I could see the abdominal wall at the bottom. That is how large and deep it was. Due to the size, it now needed a wound vac. However, in six weeks the wound completely healed. I thought it would heal all wide and huge but it did not. It filled itself in with granulated tissue (a sign of healing) and then zipped itself up from top to bottom. Now I just look like I have a line down my belly. The healed wound doesn't interfere with my appliance sticking at all.

Anyway- the point of my tale is that I would definitely ask the doc about it if it seems like the incision is doing weird things. My situation was really rare so I doubt if it is that, but I think you should inquire about it just to be on the safe side. On a positive note, though it seems like it takes forever, both the gauze or a wound vac work amazingly well to heal wounds from the bottom up. The body's ability to heal is truly remarkable. I know it is hard to look at such a scary thing happening on your belly, but it will get better. It just takes a painstakingly long time. Good luck!

Post Edited (Blueheron) : 5/19/2013 10:12:15 PM (GMT-6)

I had a lot of trouble packing mine too. My husband had to do it for me. Fortunately, he only works a few miles away from our home so he would come home on his lunch break to do it. It is pretty gross when the strip gauze gets pulled out. The way you describe it is exactly how mine looked... mucous and blood... and my surgeon said that is completely normal. Smell is a good clue too. When I finally developed that abscess I did have puss on the gauze and the wound got hot, red and painful. Hang in there. I always figured if I was going to have a complication, better to have one with my incision than something internal or involving my stoma.

Thanks BH and A&W. just spoke to my surgeon's nurse practitioner and was told we are not doing anything wrong, and to just keep it up and maybe add in more direct blood flow stimulation if the raw wound by using a washcloth directly in it during showers and/or blasting a strong shower spray directly onto it. My wife wants me to have the Local ER look at it and get their opinion. Not sure what good that will do other than waste my time sitting in ER big and little waiting rooms. Anyway, gonna get a local stoma nurse to look at it too.

PS alive and well- congrats on your surgery 2 (takedown in your case?) and good luck with the adjustment phase. I am not overly thrilled wi my current frequency and output with the ileo but I gather it really does take time and patience for that to adjust over time.