Community Forums

Suture line and hea...
 
Notifications

Suture line and healing  

  RSS

JTVT
 JTVT
(@jtvt)
Registered
Joined: 4 months ago
Posts: 49
November 17, 2019 12:57 pm  

So many questions! I’m just over 3 weeks post-end ileostomy formation so sutures (dissolvable I believe) are still in place. My stoma continues to shrink, particularly in circumference which is great but still appears quite long to me.  Seems it is longer than the 2.5cm I see commonly cited. The lumen is well centered but the stoma definitely dangles down and pulls on the top suture line. Also sometimes the side ones. Causes pinching but nothing serious. 

I’ve noticed the formation of a thicker band of skin at the top suture line and wonder if this is typical of the healing process? Stoma itself looks heathy and suture lines only bleed minimally if disturbed with gauze.  Skin looks healthy. Not concerned with infection. Had a great ostomy nurse inpatient but won’t see her for another 2 weeks as I was without too many appliance issues early on and she felt things looked good while inpatient.  Just wondering what to expect from the healing process. Will I develop that thick band of tissue circumferentially or just at the top due to the weight of the dangling stoma? I should add, while I’m super paranoid about parastomal hernias, I do not think the band I mention represents this (no change in size with increased intra-abdominal pressure). 

And one more Q! Has anyone’s previously dangling stoma become more perky after healing!? Kind of bothers me that I can’t see the lumen or underside during appliance changes unless I lift the stoma up, but at least output is directed down into the bag (got to look on the bright side). 

Thank you all for humoring all these newbie questions!


Quote
john68
(@john68)
Registered
Joined: 3 years ago
Posts: 1506
November 17, 2019 1:07 pm  

Hi JTVT, Yep there are many questions and it’s a path of discovery. Don’t be concerned about the length of your stoma cause a good spout eliminates a lot of problems. Flush or short stoma can be more prone to leaks and pancaking. I too had some crusty healing around my stoma and it soon goes. Keep measuring as it heals to get a good fit.. right you are to ask as that’s how we learn 👍


SqueakyandLiza, JTVT, LK and 1 people liked
ReplyQuote
Tony
 Tony
(@ileostony)
Registered
Joined: 11 months ago
Posts: 229
November 18, 2019 6:25 am  

Hi @jtvt,

 

These issues appear to be about right for being 3 weeks out from surgery. The band formation you mention is probably normal hypertrophy from the healing process. I would still talk to my nurse about these issues just to keep her abreast of your physiology, especially since you have specific concerns about this. The nurse will be better able to tell you whether there's enough cause for concern to warrant an earlier followup.

 

There's a possibility that your stoma may settle into a down-pointing configuration. Frankly I wish mine were like that. Your stoma, as you know, should shrink in diameter, but edema works in 3 dimensions, so it might also shrink in depth. The reason it protrudes now is perhaps that your surgeon deliberately formed it that way to try and prevent a flush stoma, which can have its own difficulties, as John pointed out.

 

I don't make these statements dogmatically. Ultimately, only you and your healthcare team can hash out what is or is not a problem and how best to proceed. However, we are happy to supply our input based on firsthand personal experience.

 

Finally, I'd like to share a short article that might provide a bit more info for early postop ostomates. Apologies if you already know all this:

 

What To Expect After Stoma Surgery - Bladder & Bowel Community


LK, VeganOstomy, JTVT and 2 people liked
ReplyQuote
SqueakyandLiza
(@squeakyandliza)
Registered
Joined: 11 months ago
Posts: 485
November 18, 2019 9:12 am  

Hi jtvt,

I will definitely second what Tony and John said - that a longer stoma would be so much better than a flush or recessed one. I have had so many problems with leaks which would be prevented if my stoma hung into the bag. 

I believe in your other post, you mentioned that you have lost a lot of weight?  That may be affecting your stoma. Perhaps as you gain back some weight, the stoma will seem to shorten??

 


LK, JTVT and Tony liked
ReplyQuote
JTVT
 JTVT
(@jtvt)
Registered
Joined: 4 months ago
Posts: 49
November 18, 2019 10:17 am  

Yes, lost a ton of weight so I suspect things will change as I get back to my healthy self. I will definitely talk to my ostomy RN but I agree that hypertrophy and differences in healing/scarring in areas of increases tension seems likely. Thanks for the reassurance about a “long spout”! As I will be saying innumerable times in the future, thank you all for the insight and support! 


LK and Tony liked
ReplyQuote
LK
 LK
(@dlkfiretruck)
Registered
Joined: 3 years ago
Posts: 740
November 19, 2019 4:57 am  

Hi JTVT...I have a longer stoma then what I read most have here. About 2 inches and with a good down spout! Gratefully so! At one point she  took a hike &  fell out a good 7 inches or so and scared the  output out of  me! I decided to lay down to think about who to call & while, thinking I watched her creep on back to where she belonged in the first place to never to show her blushing face again to this day...so far. I named her   Rose, butt  I would have called  her "sneaky snake" had the real things not  terrified or paralyzed the output out of me! The name also would have provided many a night of nightmares too, so I opted out of that one! Lol! 

In healing,  it is normal for the skin area around the stoma area, that the stoma is  stitched to, to  have a raised red swelling happening to it. So long as there is no sign of infection happening, pussy, oozy, smelly, stuff, I believe you are safe. If your really concerned, call & push your apt. closer if you can.  However, always err on the side of caution & get your doctor or stoma nurse have a peek  when you see them next.  Be sure and bring a new appliance or two along.

 No question is a dumb question and always better safe then sorry.  


Tony liked
ReplyQuote
JTVT
 JTVT
(@jtvt)
Registered
Joined: 4 months ago
Posts: 49
November 21, 2019 1:54 pm  

That’s a scary story, Linda! Glad to hear it “snaked” it’s way back in ;-) I’m heading in tomorrow for early appointment as have some separation of stoma from suture line. Damn steroids and malnutrition. Also wonder if I should have been wearing a belt or something. Hopefully it is minor and will heal. For some insane reason I though this would go smoother. Haha. Jokes on me. 


ReplyQuote
JTVT
 JTVT
(@jtvt)
Registered
Joined: 4 months ago
Posts: 49
November 23, 2019 8:42 am  

Thought I’d update just in case anyone else is in same boat in the future. Nearly one month post op. Per first visit with ostomy RN after DC, thick band formation at top of stoma (between 10 and 2) is part of healing and may or may not go away as this area is under more tension (I have a long stoma). Area of mucocutaneous separation at 6-7 o’clock (skin no longer attached to stoma) is also ok but recommending treating with power and skin protectant. It is allowed to heal like any other wound. Wanted to emphasize that she said it was good to be proactive and get on these things a early as it makes the them easier to treat. So no worry too small! Visit your friendly Ostomy RN with any concerns rather than freaking out on your own ;-)


ReplyQuote
Share: