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Mucocutaneous Seperation

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Posted 5/25/2015 5:54 PM (GMT 0)
My quadraplegic husband had a clonostopy 2 weeks ago. On day 6, the nurse noticed that his skin had pulled away from the stoma leaving a very deep crevice next to the stoma about 2 or 3 inches deep. At the same time, she realized that the opening of his stoma was also deeply embedded in that crevice. She referred him to the emergency surgeon, who came to look at it a few days later. He felt that the stoma was fine and that it would be okay to leave it as it was, but also told us we could opt to have a second surgery to have it fixed. At that time, we opted to not have the second surgery. Since then, I am home and doing some research and I am so overwhelmed with all the information. It sounds like my husband has a Mucocutaneous Seperation, which should be treated as an open wound and packed and healed up. However, if it is healed the opening of the stoma would then be trapped??? Also, if it is left open so that the stoma can operate as it should...It sounds like he will be having many many many infections. Should we be considering the second surgery? Any help or advice or words of wisdom to help me understand better what is going on will be so very appreciated.

Totally confused



Edited to add title - Shaz

Post Edited By Moderator (Shaz032) : 5/26/2015 4:30:38 AM (GMT-6)

Posted 5/25/2015 8:32 PM (GMT 0)
Jeez, seek a second opinion ASAP. It sounds like the stoma has severely retracted. Either way it doesn't sound good. Make sure it's a colorectal surgeon you speak to and not a general one, which the emergency surgeon probably was.

Hope you can get this sorted out soon.
Posted 5/26/2015 1:15 AM (GMT 0)
Hey Eva, like NCOT suggests; the sooner the better. Please don't underestimate the importance of the surgeon's qualifications. Sorry if this suggestion scares you but I think it needs attention very soon by a very qualified surgeon. Please keep us posted with some good news real soon.
Respectfully,
Michael A
Posted 5/26/2015 2:42 PM (GMT 0)
I have to agree w/the others-- see a colorectal surgeon, soon, and perhaps also an ostomy nurse. In some circumstances, you could pack the wound and use a convex wafer, but not if the output is going right into the wound, which seems like a risk of infection. This situation sounds like it would be incredibly painful, but your husband probably can't feel it due to his quadriplegia

On the other hand, if there's something your missing and there is a way for things to heal without surgery, a good ostomy nurse can figure out how to dress the wound and make the ostomy appliance work. Also, if you can get in to a nurse first, and you do need surgery s/he will probably know it and might be able to help you expedite making that happen.

Hope things get better soon.
Posted 6/4/2015 2:28 PM (GMT 0)
Someone should be able to help with a really close up photo. There is a Stoma nurse's association if you cannot get to a colorectal surgeon quickly. See if you can email it around.
The space between the Stoma and the skin can be frighteningly deep. Our surgeon opted not to pack it , so we did daily dressing changes . Finally stopped at the 8 week mark when the skin healed to the surface. The last loop illeo had retracted too, but worked with a convex wafer. No stool leaked into the body cavity that I know of.
Is your husband leaking stool inside, or is it hard to tell?
Posted 6/4/2015 4:33 PM (GMT 0)
Ditto the above responses Eva.
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