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Stoma case sharing

There are various complications after stoma surgery due for various reasons. One of them was a new granuloma growing around the stoma. That is the early complication of stoma - "stomal mucosal granuloma", this is granulation hyperplasia, also called mucosal granuloma, basically most people with a stoma will encounter such problems. It's usually benign and nothing to worry about. Some people with this kind of granulation hyperplasia have no obvious symptoms, and some people feel redness, swelling, pain, and may be damaged and bleeding. This article will introduce these common complications and how to deal with them. Please take a look with me below.

The picture below shows "stomal mucosal granuloma"

Summary: From the picture above, it can be seen that there is a circle of small bumps around the stoma, and there is redness and swelling.

What is Mucosal Granuloma?

Polypoid hyperplasia occurs at the junction of the mucous membrane and the skin tends to bleed easily and is usually benign. It often occurs where the stoma mucosa meets the skin, and one or more pieces can grow around the edge of the stoma, or it can also occur on the stoma mucosa. The mucosal granulation that occurs at the edge of the stoma mucosa not only causes pain, and itching, and is easy to be accompanied by bleeding, but also affects the adhesion of the stoma bag, which is likely to cause leakage and lead to peristomal dermatitis.

What are the reasons for this?

① Suture reaction - the end of the suture around the stoma is completely detached, the inflammatory changes of the stoma mucosa caused by suture stimulation, the proliferation of tissue cells, and the formation of peristomal mucosal granuloma

② Chassis cutting - the cutting of the stoma chassis is not appropriate, the central hole of the chassis is cut too small or the burr of the inner ring stimulates the proliferation of fibrous tissue, resulting in stoma mucosal granuloma

③ Chassis material - the hard chassis stimulates the edge of the stoma.

General granulation hyperplasia is a normal reaction of the skin, so there is no need to worry about stoma problems. Nursing advice:

1. During the wound period, every time you change the bag, be sure to clean the surrounding skin and wound and pay attention to disinfection. If there are sutures remaining, go to the hospital to remove them in time.

2. To prevent leakage, replace the ostomy bag in time to avoid repeated infection of the wound caused by excrement leakage.

3. The convex chassis can be used, and the granulation hyperplasia can be inhibited to a certain extent through pressure.

4. When cutting the central hole of the stoma, pay attention to the appropriate size, not too small, so as not to be too tight and irritate the wound.

5. If the granulation hyperplasia is serious, it is recommended to see a doctor. It can be removed by laser, cauterization, etc., so as not to affect the care of the stoma.

How to prevent granuloma?

Here are some tips to prevent granulomas :

1. should be minimized to prevent bleeding.

2. Make sure the pouching system fits; resize the stoma opening of the pouching system and use an ostomy seal as needed.

3. Apply a layer of barrier cream at the mucocutaneous junction.

4. Avoid wearing tight clothing/belts around the stoma/ostomy area.

Does granuloma recur after treatment?

Granulomas can still recur if not properly cared for. If a granuloma doesn't cause you any bleeding or discomfort, it's nothing to worry about. If you feel unwell, please contact your optimist immediately.

For more information on Innomed® ostomy attachment, refer to the previous articles. If you have customized needs, you are welcome to contact us; we will serve you wholeheartedly.

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Editor: kiki Jia

Date: January 6, 2022