Stoma retraction refers to the situation where the stoma, which is the artificial opening created for drainage of bodily fluids, no longer lies flat against the skin surface. Instead, it appears sunken or recessed, often extending below the skin's surface. This condition can arise for several reasons, including:
-
Ineffective Adhesion: If the skin around the stoma becomes excessively dry or inflamed, it can become adhered strongly to the surrounding skin, making it difficult to adjust or replace the stoma bag.
-
Loose Stoma Bag: A poorly fitted or deteriorated stoma bag may not sit snugly against the skin, allowing for excess pressure to build up and cause retraction.
-
Abnormal Stoma Shape: Certain types of stomas, such as loop ileostomies, may protrude more due to their design.
-
Skin Change: Changes in the skin around the stoma, such asthickness or stretchiness, can contribute to retraction.
-
Weight Gain: Rapid weight gain has been known to contribute to stoma retraction in some patients.
-
Postoperative Complications: In some cases, stoma retraction may be a consequence of complications following the original creation of the stoma, such as abscess formation or a narrowing of the stoma track.
-
Surgical Techniques: The approach used during the original creation of the stoma can also impact the ability of the stoma to retract. Large incisions may lead to greater tension on the surrounding skin and muscles, potentially causing retraction.
Symptoms of Stoma Retraction
Symptoms of stoma retraction can include:
-
Redness or Inflammation: A dark red or purplish color in the area around the stoma may indicate blood flow, while inflammation can cause swelling and tenderness.
-
Leakage: Increased fluid output may occur, particularly from the ileostomy, which can cause skin irritation or wetness.
-
Discomfort or Pain: The skin around the stoma may become painful, itchy, or painful to touch.
-
Disruption with Appliances: The adhesion between the stoma bag and the skin may break down, leading to leaks, skin breakdown, or appliance failure.
Diagnosis of Stoma Retraction
Diagnosis of stoma retraction typically involves a physical examination by a healthcare professional, who may also request imaging tests like CT scans to assess the extent of the retraction.
Management of Stoma Retraction
Treatment and management of stoma retraction can vary widely depending on the severity and underlying cause. Generally, conservative measures are tried first. This can include:
-
Corrective Surgery: The retractor can be released by a surgeon to allow the stoma back to its original position or the creation of a new skin using techniques such as nonautologous tissue expanders.
-
Reconstruction: Reshaping the surrounding skin and muscle with nonautologous tissue expanders for reconstructing the retort area.
-
New袋款: Switch to a new stoma bag with a larger opening to accommodate a retracted stoma.
-
使用皮肤扩张器: 如果是因瘢痕形成而引起的，可以通过皮肤扩张器逐渐扩宽皮肤。
Prevention of Stoma Retraction
Preventing stoma retraction is generally aimed at maintaining good stoma health through careful management of wounds, preventing infections, managing excess tension around the stoma, and keeping the skin around the stoma clean and healthy. This may include keeping the area around the stool clean and avoiding friction with clothes, avoiding constipation or diarrhea, and avoiding heavy lifting or straining during bowel movements that could increase tension on the stoma.
Stoma retraction is a relatively common condition that can significantly impact the quality of life for ostomates. Prompt diagnosis and management by a healthcare professional skilled in stoma management is crucial for successful treatment and prevention.
References
文章仅供参考，请以医生诊断为准。
