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Mucotaneous Separation

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Posted 6/14/2013 2:06 PM (GMT 0)
I just recently (not quite 2 weeks ago) underwent emergency surgery due to a small bowel obstruction that was caused by what my surgeon thought for months was scar tissue (I had been having repeated bouts of sbo for over a year). Turns out there was absolutely not a trace of any scar tissue but a twist of the mysentery. They stitched it to the abdominal wall and redid my stoma.
Stoma is bigger, stands out further and the spout is more to the centre all great! However I've got some mucotaneous separation and when I discovered it I panicked and we took me back to the hospital and the dr said it was fine but to get in touch with my stoma nurse. She is away until Monday and I'm wondering if anyone has experienced this and what they did to help it heal? It burns something awful and I'm having trouble with getting a good seal which is the biggest trouble because it keeps getting leakage in there.
Anyone got any ideas?
Stacey
Posted 6/14/2013 3:33 PM (GMT 0)
Do you use a barrier ring like a Hollister Adapt or Eakin seal? I had a small separation with my second ileo and the stoma nurse told me to just place the barrier ring over the separation/snugged against the stoma itself, as the most important thing is to keep waste out of the separation. If it's very "wet" you can also use stoma powder over the separation before applying your barrier ring. My separation was relatively small (one of my stitches popped shortly after surgery because of a coughing fit) and it healed completely in about 10 days.

Hope this helps. If the separation is large the stoma nurse may choose to pack it as well, I think ActiveUCer might have gone through this if I recall correctly.
Posted 6/14/2013 5:35 PM (GMT 0)
Yes I did do that last night when I changed it problem is I find that the ring or strip blows up into the hole of the wafer and disrupts the flow of output from my stoma. It sticks out now but not super far so when the ring blows up in there it causes it to leak a little under the wafer. I did put powder in there as well which seemed to soothe it some. It's oozing a little bit so I'm worried about it getting infected and having trouble there. Figures the stoma nurse is away right now that's just my luck. How often is too often too change it as well? I've been doing a lot of changes since I came home and running out of supplies soon. The hospital set me up in a program through one of the companies but I haven't received the sample package yet. Im kinda wondering if one of my old light convex wafers might help with the ring issue? Someone suggested using paste to fill it in but for one it burns so bad and two I have the worst time maneuvering it it sticks to everything but what I want it to. Any tips there anyone?
Posted 6/15/2013 6:22 PM (GMT 0)
When I had a mucotaneous separation my stoma nurse had me pack it with a dressing called Melgisorb that is derived from seaweed. I would take some fibers off the Melgisorb sheet (it looks like a felt sheet) and put them in the wound opening. Then I put my barrier ring and wafer over it. It was gentle and kept output out while promoting healing. My nurse said stoma powder works in a pinch but that this was much better. Ouch! Putting stoma paste in the wound would hurt! If you have to though, I think Hollister Adapt Paste is one that doesn't contain alcohol (some of the others like Convatec to contain it) so maybe the Hollister brand won't burn as much.

http://www.molnlycke.com/patient/en/Products/Wound-care-products/Melgisorb-Ag/
Posted 6/24/2013 2:15 PM (GMT 0)
Thank you Blueheron. I am going to call my ET nurse today and ask her about it. The wound is exuding enough liquid that I'm not able to get a good seal and I am changing pouches every two days at least. My skin is not happy about it. \it doesn't help that my incision is so close to the stoma area that I have to cut off the side of the flange. The paste does sting alot, I've switched to using the paste strips from coloplast they seem easier to work with and they don't sting or blow up into the hole like the eakin rings seem to on me. I think Salts makes a paste without alcohol too but I haven't tried it.
I actually had a huge leak in the night last night and thank goodness for a good supportive fiancee who helps me! I've been really anxious since coming home with everything that has happened in the last couple of years I keep expecting something bad to happen... so far though my ostomy seems to be working.
Out of curiosity approximately how long did you have the separation for?
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