Early complications include stomal necrosis, dehiscence and retraction. Later complications include stomal stenosis, parastomal hernia and prolapse. Other complications that may occur at any time are bleeding, peristomal skin excoriation, bowel obstruction and high stomal output.
The most common early complications of stoma creation include improper siting, vascular compromise, retraction, peristomal skin irritation, peristomal infection/abscess/fistula, acute parastomal herniation, and early postoperative bowel obstruction.
Stoma Skin Problems
Issues or problems with the skin around the stoma is probably the most common complication for ostomates. Not only is having sore skin extremely uncomfortable for the patient but it can also compromise the attachment of the bag to the skin causing leaks and leading to further skin damage.
Late complications include parastomal hernia, prolapse, retraction, and varices.
Signs of Skin Problems Around a Stoma
The skin around the stoma appears infected and/or is red and "angry" in appearance. There is a pus-like discharge. The skin color suddenly changes. The skin is irritated by the stoma appliance, causing redness, chafing, or a raw or "burned" appearance.
Stoma blockage
Some people develop a blockage in their stoma as the result of a build-up of food. Signs of a blockage include: not passing many poos, or passing watery poos. bloating and swelling in your tummy.
The suggested guidelines are that if your blockage lasts any more than 8 hours with no movement, you should go to the hospital because it might need surgical intervention!
Most people with stomas may have to go through a stoma infection. However, it is a possibility that anyone with a stoma should know about it. The first sign of a stoma infection may be a pus-like discharge, unusual swelling, increasing redness, or color changes.
Many people enjoy leaving their skin uncovered for 15 to 30 minutes after taking their pouching system off. This is called a skin break. Taking a skin break can help with irritation or keep it from happening. You can decide if you want to take a skin break.
Air from the stoma causes the bag to expand and detach from the skin (ballooning) Ballooning occurs when air from the stoma inflates the bag and cannot escape through the filter. The resulting air pressure can cause the adhesive to detach from the skin.
Common complications include poor stoma siting, high output, skin irritation, ischemia, retraction, parastomal hernia (PH), and prolapse. Surgeons should be cognizant of these complications before, during, and after stoma creation, and adequate measures should be taken to avoid them.
But don't worry: a stoma prolapse is not life-threatening. With care and management, most cases of the prolapsed stoma can be treated without requiring surgery. Even if you don't have a prolapsed stoma, there are a couple of ways to prevent it from happening.
Try lying down and lifting your knees to your chest, rolling gently from side to side. For people with a colostomy, your GP or stoma care nurse may prescribe some laxatives, use these as prescribed and don't forget to drink plenty of water with these as it will help them work better.
In emergency surgery a stoma may be a lifesaving procedure to control sepsis during the acute illness, this normally get reversed when the patient has fully recovered. Due to time constraints pre-operative counselling and planning are not possible especially when operating out of hours.
Start by looking for ostomy output, either on your skin or on the back of the barrier upon removal. Even if there is no direct visual sign of leakage. Be aware of anything unusual, such as if the barrier looks 'melted' (because the barrier may have reacted with the output).
The rates of stoma complications reported in the literature vary widely, ranging from 10 to 70% [7, 9, 10]. The risk for complications from stoma creation is lifelong, although complications have been reported to be most frequent in the first 5 years postoperatively [7, 9].
If the procedure is straightforward, reversal of a loop procedure takes about 30-45 minutes. However, if extensive adhesions arising from previous surgery are found, more extensive surgery may be needed to free up the bowel ends, which may take up to 2 hours.
Living with a stoma is a challenging situation for various reasons including uncontrolled gas passage through it, odor, diarrhea, and leakage around the stoma or appliance. It would take several months for the patients to adjust to this difficult time.
A colostomy is an operation to create an opening (stoma) of the large bowel (colon) onto the surface of the tummy (abdomen). Your poo no longer passes out of your body through your back passage. Instead, it passes out through the stoma. You wear a bag that sticks onto the skin over the stoma to collect your poo.
Blood supply must be meticulously maintained to prevent ischaemia and necrosis, mainly in end stomas and above all when some of the vascular arcades require ligation. A correct opening in both skin and fascia is important to prevent narrowing which may lead to ischaemia or stenosis.
These micro-organisms can easily multiply when you have a stoma because the area is warm, humid and soiled. They may colonise the stoma without causing any major issues. But for those who suffer with general ill-health, diabetes or those who take immunosuppressive medications, infections are more likely to occur.
This pain is often due to intercostal nerves caught in scar tissue or even stitched when the surgeon closes the site. This can lead to irritation and inflammation that produces a burning or stabbing sensation in the area of the colostomy site. Most people experience radiating pain from the abdominal wall to the side.