Troubleshooting-Workshop

Skin Problems

• Reaction to appliance

• Bacterial or fungal infection

• Folliculitis

• Pre-existing skin conditions. Eg. Psoriasis, eczema

• Pyoderma gangrenosum

• Hyperkeratonic Encrustations

Hyperkeratonic Encrustations

Faecal Excoriation

Pyoderma Gangrenosum

Folliculitis

Pre-existing Skin Condition

Reaction

Parastomal Hernia

Prolapsed Stoma

Bleeding from stoma

• Bleeding from surface of stoma

• Bleeding from lumen of stoma

Granuloma

• Excess granulation tissue caused by friction from appliance or a foreign body. Eg. A stitch

Pancacking

• Faeces remains stuck around the stoma and does not drop into the bag

Rectal Discharge

• This can be normal after surgery when the rectum or rectal stump has not been removed

Mucocutaneous Separation

Stenosis

• When the lumen of the bowel becomes narrow. May be a complication of muco-cutaneous separation

• Dilation

• Diet to keep stool soft

Scenario 1

A 62 year old man asks to see you for some advice about a sore, red area around his stoma. He had surgery 3 months ago and has an ileostomy.

Scenario 2

A 42 year old lady asks for some advice about sore skin she has

around her colostomy.

Scenario 3

• A 75year old lady visits clinic complaining of appliances not sticking and leakage. Also complaining of a ‘swelling under stoma’ She has had a colostomy for 2years for a rectal cancer

Scenario 4

• A man of 33 years attended clinic complaining of emptying his pouch frequently. He has an ileostomy for Ulcerative colitis 6 months ago.