UOAA Discussion Board

Hello.

This is an ostomy adjacent question. Forgive me if I shouldn't post it or it should be under a different topic board.

Has anyone here been in a position where they have to take care of a wound? Especially associated with surgery that resulted in having a stoma? My wife had emergency surgery to close a fistula and then had also got a stoma. I'm hoping the wife can get into wound care at the local hospital. She was in a critical care hospital and when released it was assumed she could get home health. Insurance said otherwise. So, I'm having to take care of the wound and the ostomy until we can get professional help. We were given a sheet of collagen paper to put in the wound. The wound nurse at the critical care hospital said it should last till the wound is healed. Several leaks from the ostomy into the wound took care of that sheet!

So, I'm looking for a collagen something to put in the wound when I bandage it up. I ordered some collagen powder that goes into wounds. Anyone have experience with using collagen in wounds? I'm not sure collagen dressing would get down in there. Maybe it would?

She is drinking a package of Juven twice a day. No doubt that is helping with the wound. I hope it is helping with the fistula that hasn't quite closed up after it had burst after surgery.

Thanks.
Greg

Oh good, I see you explained what your wound is. So now I know.

I recall when I had my surgery that when output from the stoma entered the wound that it first had to be cleaned out with saline, gauze and a small stick or something. Flushed out and dried a bit.

Then they put some lite new gauze in the wound, wetted first with saline, over it a little so it would air out and then covered the area mostly with tape as to deflect stoma output from going back in there.



It had to be replaced frequently (like everyday or two days) because the wound will heal up with the gauze in it and be painful and bloody to remove.

So I would use tape to create a deflection wall to keep output from going in the wound.


Take some 1" or so wide tape portion, crease it in half and then each half fold that half that outwards as to create a little wall you can place along the open wound, if there is room that is.


Your wife is still in her surgery recovery stage, she can't use a convex yet because the belt required will go over the surgery wound and place pressure on it, obstruct cleaning etc. may heal wrong.. So not yet, later when it scars up more. Again a convex won't stay in place without the belt and extra adhesive strips. Bend the flat wafer a little to fit better IMMO. If the paste, ring, paste sandwich is working for you go for it. A convex is a circle of depressed curve all around, the adhesive portion of the wafer doesn't come into contact with the skin as it's pushed up, why it needs the depressing power of a belt to keep it down and handle unevenness and keep it down or it comes off. But with a ring and paste you can adjust as needed. High side less paste and so forth. So since no belt your stuck as is until that wound heals.

She should be draining her otosmy bag to the right so it works while laying down where she should remain most of her time until that wound heals up better. Infection rate is high during this time with an open wound, so take appropriate sanitation steps. I would drain pouch before she needs to get up or sit up. Being vertical with a full bag will place pulling pressure on the adhesive and paste, cause a leak. A belt later on will assist keeping the bag on under weight.

She shouldn't sit up completely to eat as that causes a bag to leak, rather she likely will have to eat very soft foods that won't cause a clog (ground beef, boiled chicken, noodles, mashed potatoes, fruit and vegetable juices etc) yogurt with breakfast for the bacteria, either fed to her or by her own (sterilized) hands while head raised a little. The more she bends, the more chances of a leak. Roll sideways out of bed and try to stand up right away with assistance without bending over at the waist.

It's unfortunate you don't have sufficient insurance to handle aftercare, I had the same problem but had to do it alone unfortunately. Not fun.

You should get a home nurse, that's what I had to do and when one was finally arranged I had things under control myself by then.

Be advised I'm not a trained medical person, not there in person and only offering my experience based upon my similar experiences. Consult with a certified professional before taking any advisement received. I doubt saline would be harmful but perhaps it is in your case. So always double check any advice from anyone.

Not sure my experience is relevant to your wife's situation but my go-to for bad wounds years ago was hydrofera blue. I had to put something over it for keeping it in place, say a bit of brava sheet, but it helped heal granulation tissue and a weird hole that developed when a plastic surgeon put the nitrate stick somewhere unexpected.