How to deal with stomal edema?

How to deal with stomal edema? - HEAGI - Colostomy bags Specialist
Stoma edema refers to the swelling of the stoma mucosa, which manifests as varying degrees of swelling of the colostomy mucosa, and is the most common complication after colostomy. The initial postoperative edema is reddish, translucent, firm in texture, and varies in color from pink to dark red. Mostly due to blood reflux disorder, no symptoms, mild edema can recover naturally after 6-8 weeks. If the edema of the stoma tissue is not relieved for a long time, it is related to the tight wrapping of the tissue around the wound edge, infection, removal of stoma stenosis and obstruction of venous return. If the stoma mucosa is edematous and is grayish-white at home, you should check whether the blood supply to the stoma is normal.

Various degrees of edema can occur after any type of enterostomy, including ileostomy, colostomy, and urostomy.

What is the cause of ostomy edema?
1. During the operation, the opening of the abdominal wall and skin is too small, and the blood return of the intestinal tube is not smooth, resulting in edema of the enterostomy

2. Wearing the abdominal girdle too tight leads to stoma edema

3. Improper cutting of the stoma chassis after surgery, the center hole of the chassis is too small, compressing the surrounding of the stoma canal, affecting blood flow and causing stoma edema

4. Hypoproteinemia. When the protein content in the blood is too low, the water in the blood will penetrate into the interstitial space, which will lead to enterostomy edema.

5. Local tumor Local recurrence of tumor stoma forms compression, leading to obstruction of blood flow back into the stoma, resulting in intestinal stomal edema

6.The length of the bowel and the double-loop stoma of the support rod. During the operation, the bowel is not sufficiently free or the patient is too obese, the tension of the bowel is too large, and the pressure of the support rod will cause stoma edema.

1. Mild edema does not need to be treated temporarily. Because most colostomy patients will have mild swelling in the early postoperative period, this edema will gradually relieve itself within 6-8 weeks after surgery, and usually does not cause damage to the patient.

2. Severe edema (usually occurs about a week after surgery), then use gauze dipped in 50% magnesium sulfate solution or hypertonic saline (3% sodium chloride solution) to cover the enterostomy mucosa, 2-3 times/ day, 20-30 minutes/time. It is advisable to stick the ostomy bag before wet compress to avoid discomfort caused by wet clothes.

3. Choice of ostomy bag. In the early stage of edema, when the volume of the enterostomy is large, it is advisable to use a pouch with a larger diameter in the center hole of the chassis to avoid mucosal erosion caused by friction between the pouch and the intestinal mucosa. A small amount of gas can also be placed in the pouch to prevent friction.

4. In the early postoperative period, except that the inner ring of the ostomy bag chassis should be slightly larger, the abdominal girdle should not be too tight, and the stoma should not be completely tied in the abdominal girdle.

5. For patients with enterostomy edema caused by hypoproteinemia, they should actively follow the doctor's advice to correct the patient's protein level, treat the primary disease, and pay attention to the treatment effect in the later stage.

6. The color of the stoma with edema should be closely observed to avoid ischemic necrosis. Avoid colostomy mucosal injury and ischemia.

Reminder: This article does not represent the basis of medical diagnosis, please stoma friends mainly check in the hospital!


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