My client has had an ostomy for a few years, developed a hernia but could not have any further surgery done...last year she developed Umbilical Ca with mets to abd wall....she received a course of radiation followed by chemotherapy....her stoma was 1 1/4 "...then reduced to 1 1/8 ' then to 1" with the chemo...The problem is the inferior aspect of the stoma is smaller than the superior asp....making the opening face downwards and causing leakage.... now we have an ulcer to the peristomal tissue at the medial asp....the leakage starts at about the 7 oclock position...we have had the ET visit and none of her suggestions have worked...with the chemo, the client often has to change the wafer 3x/24hrs.... even when the diarrhea is under control with anti-diarrheals, the soft pasty stool pushes under the rim......at this point, ET and 4 different nurses have tried to come up with a way to prevent the stool from leaking under the wafer and onto the ulcer...
any suggestions would be greatly appreciated ....
Jan 23, '13
Stoma revision? If that is now possible..Is there an uneven area that is making the appliance not lay flat? Was there less leakage with thinner stools? Hard to say with what info you have given us. In the meantime you probably already are using a skin prep to make a barrier to keep the skin from having stool irritate it??
Last edit by funfunfun550 on Jan 23, '13
: Reason: additional comments