I had a jpouch redo and mucousectomy in Cleveland 6+ weeks ago and have had numerous problems - one being wounds around my temp. loop ileostomy. A large one was at 9:00 which seems to have healed, or at least mostly healed. There's another at the bottom of the stoma. You can't see it unless you lift the stoma, but apparently it's deep enough for a surgeon to have inserted a good part of his forceps into it. At the time it wasn't oozing very much and it was the other wound that seemed to be more of a problem. I've been working with osotmy/wound care nurses and a local surgeon, but things are still not good. The surgeon had me get a cat scan to be sure there was no abcess and said that I either can hang in there till my takedown or would need a surgical revision. Obviously I don't want any extra surgery, especially not with a different surgeon. He also wants me to stay on Cipro till my surgery to prevent any increased infection.
In the meantime, the wound seems to be oozing much more. So much so that I can barely keep an appliance on for a day. It just comes pouring out from under.
Please! Any advice? Reassurance?
I also am terribly uncomfortable. Always feeling like everything's being tugged, itching, burning around stoma...

I have a similiar problem. I had J-pouch surgery on sept 4th and have had lots of problems with my stoma that hunches over & downward. Had to try many different appliances & methods to get it under control. About a week or more I noticed like my skin pulled away & made a hole under my stoma about half way around. About 3/8 around & pretty deep & the skin very red! Leakage again became a big issue. I am finally getting it under control by putting powder in the wound & skin barrier spray around stoma & then using putty or Ekin seal to plug hole & level out skin. Appliances now are lasting 3 or 4 days again! Shell is a big help in advice toward these problems! You'll get it under control, hang in there!
Danny

Hi Wendy,

It sounds like you have a peristomal ulcer. I had several of these appear shortly after I had my j-pouch removed and Wee Willie (my end ileo) installed. I had absolutely no healthy skin between the ulcers and my stoma so it was virtually impossible to keep a wafer on for any length of time. Unfortuanlety they are notoriously difficult to heal. Like you I couldn't keep an appliance on because of the infection oozing from them. I was actually hospitalised with them and at that time was having to change my wafers 3 times a day or more. It was expremly painful and left me feeling sick every time I had to do an appliance change.

With the help of my very good friend and stoma/wound care nurse Marlene, we came up with a regime that finally helped to close the ulcers. I used a product called Promogran. http://www.dressings.org/Dressings/promogran.html It looks like very thin styrofoam and I would cut small pieces the same shape and size as the ulcers which I then used to pack the ulcers. Then I applied a piece of Duoderm over the top of the Promogran and my wafer over that. The Promogran helped to soak up the oozing puss and promoted new granulation of healthy tissue. The Duoderm provided something for the wafer to stick to and also protected the ulcer from stool. If you can't get hold of any Promogran then you might want to try Granuflex instead as that also promotes granulation in ulcers. Here's a link to Convatec's Duoderm and Granuflex wound care dressings.

http://www.convatec.co.uk/convatec/jsp/CVTOnlineProduct...d&lang=en&country=GB

How long is it before your takedown? If it is pretty soon then you could probably hang in there. Once you've had takedown the ulcer will have a much better chance of healing. If the situation becomes really intolerable then you might want to consider a stoma revision.

I really hope that you can get this under control soon. Please let us know how you get on.

Take care

Shell

Thanks so much to you both for your replies.
Danny, who's your surgeon? Are you also by any chance having trouble with your rectum throbbing and aching? I have all this mucous secretionn and started doing kegels to get my sphincter toned so they won't delay my takedown. But since I started a few days ago, the aching that had pretty much calmed down is now really bad again.

My surgeon is Dr. Robb at Indianapolis University in Indiana. Yes, after my take down, some days every time I urinate I have an urgency & sometimes out of the blue I feel the mucus want to slide out & have to rush to the bathroom. I too try to do those exercizes as often as I remember. The stool is like a clear waxy substance. Some days I am fine & no urgencies! I just have to always be on the alert for those signs or leakage around my bag. I'll pray for you tonite! Though the storms never cease to come,He is always faithful to bring me through! I battled UC & Bladder cancer the same time. UC for 10years and treatment for bladder cancer for 5 years. Plus I've had prostrate biopsies four times for high PSA and enlarged prostate, so I've been on the battle field awhile! Hey it makes you care about people & not take life for granted!
Danny