Mucocutaneous separation complicate

Mucocutaneous separation complicates ostomy management when it forms a cavity that partially or completely surrounds the stoma. There may be excessive drainage from the presence of necrotic tissue in the wound base. The area of separation should be irrigated with normal saline and filled in with an absorptive material such as a calcium alginate, skin-barrier powder, or hydrofiber.11 Skin-barrier paste or strips may also be used like caulk to fill in the crevice, separate the absorptive filler from effluent, and provide a flat pouching surface. The ostomy wafer can then be fitted over the wounded area to protect it from effluent, leaving just the stoma uncovered. Excessive drainage may require frequent changing of the pouching system to exchange the absorptive material and assess healing.11 A 2-piece appliance may allow easier access to the wound for frequent assessments.


When stomas are constructed and surgically matured, the distal bowel is exteriorized and everted with the edge sutured to the peristomal skin. In the immediate postoperative period, stomal swelling increases during the first few days until around day 5 when it begins to subside.8 A convex appliance (see the following section) may exert pressure or constriction upon this newly created mucocutaneous suture line. This can consequently impact healing and cause a separation at the mucocutaneous junction, particularly in the patient who is often already nutritionally compromised.18 Though further research is needed to determine the true impact of convexity upon mucocutaneous separation, clinical experience suggests that the early use of convexity should be avoided if possible.17 Stomal stenosis or retraction may occur when a mucocutaneous separation heals by secondary intention.8 Stomal retraction with complete mucocutaneous separation below the level of the fascia is managed as a surgical emergency.17

ผลลัพธ์ (อังกฤษ) 2:

Mucocutaneous separation complicates ostomy management when it forms a cavity that partially or completely surrounds the stoma. There may be excessive drainage from the presence of necrotic tissue in the wound base. The area of separation should be irrigated with normal saline and filled in with an absorptive material such as a calcium alginate, skin-barrier powder, or hydrofiber.11 Skin-barrier paste or strips may also be used like caulk to fill in the crevice,. separate the absorptive filler from effluent, and provide a flat pouching surface. The ostomy wafer can then be fitted over the wounded area to protect it from effluent, leaving just the stoma uncovered. Excessive drainage May Require Frequent changing of the pouching Exchange System to Assess the absorptive Material and Healing.11 A 2-piece Appliance May Allow Access to the Wound easier for Frequent assessments. When STOMAS are surgically constructed and matured, and the distal bowel is exteriorized. everted with the edge sutured to the peristomal skin. In the immediate postoperative period, stomal swelling increases during the first few days until around day 5 when it begins to subside.8 A convex appliance (see the following section) may exert pressure or constriction upon this newly created mucocutaneous suture line. This can consequently impact healing and cause a separation at the mucocutaneous junction, particularly in the patient who is often already nutritionally compromised.18 Though further research is needed to determine the true impact of convexity upon mucocutaneous separation, clinical experience suggests that the early use of. convexity should be avoided if possible.17 Stomal stenosis or retraction may occur when a mucocutaneous separation heals by secondary intention.8 Stomal retraction with complete mucocutaneous separation below the level of the fascia is managed as a surgical emergency.17.