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Thread: Supra-Pubic Site Won't Heal

  1. #1

    Supra-Pubic Site Won't Heal

    Any suggestions on how to get a supra-pubic site to heal? I had the surgery for this some time ago and the site won't fully heal...

  2. #2
    Without being able to see the site, it is difficult to know exactly what is going on.

    Is the site red (how big of a red area around the hole-size of a quarter/half dollar)? Does the site ooze? Is the site cracked and bleeding around the stoma hole. Have you had a catheter changed? Did you doctor offer any opinion about the condition of the site?

    How do you take care of the stoma site? The area needs to to washed twice a day with mild soap and warm water and thoroughly dried. If the skin is cracking around the stoma, you may need a bit of moisturizer, massaged into the skin. If there is a bit of infection going on, you may want to use a thin film of an over the counter antibacterial ointment, Vetericyn hydrogel or swab the area with Vetericyn liquid.

    If the hole is oozing small amounts of lymph or blood, it may be that the hole is healed, but you are getting some blood or lymph on top of the balloon from irritation of the bladder wall and that is working its way up the catheter to the outside of the stoma. Do you tape or use a catheter holder that holds the catheter in place to avoid "pistoning"...movement of the catheter in and out of the bladder which would irritate the stoma walls and the bladder walls around the balloon?

    All the best,
    GJ

  3. #3
    Is this a SP site that you are still using (has a catheter in place) or is it one that you had removed and refuses to close? How long did you have the stoma? A little more information would be helpful.

    (KLD)

  4. #4
    Yes the site is cracked and bleeds around the stoma hole especially when the area is washed w/ soap and water or the indwelling catheter is changed. I had the surgery about 6 years ago. There's no infection in the area but it refuses to fully heal...we've tried asking my doc and she also suggested taping the catheter tube so it doesn't pull. And yes I use a catheter positioner.
    This didn't help much.

  5. #5
    Quote Originally Posted by QuadPowers View Post
    Yes the site is cracked and bleeds around the stoma hole especially when the area is washed w/ soap and water or the indwelling catheter is changed. I had the surgery about 6 years ago. There's no infection in the area but it refuses to fully heal...we've tried asking my doc and she also suggested taping the catheter tube so it doesn't pull. And yes I use a catheter positioner.
    This didn't help much.
    Try using a milder soap (try Cerave skin cleanser), making sure the area is thoroughly rinsed and dried and then using a moisturizer (Cerave cream or lotion is excellent). I think the area is healed, it is just a dermatology issue now.

    All the best,
    GJ

  6. #6
    Thanks...Kyle

  7. #7
    Also, be sure that the catheter is not causing pressure on the edge of the stoma. It is recommended to place a small "bolster" made from a folded 4X4 gauze, taped in place, under the catheter as it exits the stoma, in the direction of the securement device. I will attach a crude drawing of this.

    If you have hypergranulation tissue ("proud flesh") around the stoma, then a silver nitrate stick treatment may help it heal.

    (KLD)
    Attached Images Attached Images

  8. #8
    Quote Originally Posted by SCI-Nurse View Post
    Also, be sure that the catheter is not causing pressure on the edge of the stoma. It is recommended to place a small "bolster" made from a folded 4X4 gauze, taped in place, under the catheter as it exits the stoma, in the direction of the securement device. I will attach a crude drawing of this.

    If you have hypergranulation tissue ("proud flesh") around the stoma, then a silver nitrate stick treatment may help it heal.

    (KLD)
    If you have extremely sensitive skin, on your belly and around the stoma be careful of the type of tape or any tape you use in this area. I still have scars from what looks like burns from using tape on the belly flesh just after the supra pubic surgery. The best I can do is secure the catheter at the top of my thigh. The belly flesh just can't take adhesive (even 3M Micropore with or without skin preparations for adhesives).

    All the best,
    GJ

  9. #9
    Yes I believe the problem is hypergranulation tissue...

  10. #10
    After reading the response which mentioned hypergranulation tissue, I was interested to see if I could find anything on the internet and I searched "hypergranulation tissue suprapubic catheter." I found this post to a thread on the Apparelyzed website forums. http://www.apparelyzed.com/forums/to...ubic-catheter/

    partygirl
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    Posted 24 August 2010 - 05:08 AM
    I have a SP catheter, mine has been in for 3 years, after about a year I also began having hyper granulation problems.
    Mine has been treated a number of different ways over the past 2 years.

    For a long time mine was treated with silver nitrate but I don't recommend that. The process is by touching the extra tissue with the tip of a 20cm stick that is coated in the silver nitrate which has a caustic affect on the damp mucous membrane ie it burns it. If you have sensation (which I fortunately don't) it stings like hell and some people find it too painful to proceed. The burnt flesh sloughs off the next day. There are also types of silver impregnated foam dressing squares that can be applied, I tried them but they didn't work on me.

    I now have a system that is keeping over granulation under control and my stoma nice and clean. I apply a small dressing at home each morning that is a dab of an ointment called 'Kenacomb' right on the stoma entrance, cover with a 3cm square of a super absorbent foam dressing material, then some adhesive over the top to keep it in place. i think the ointment is by prescription only and is probably called something else in the UK, so this info may be of little use to you.

    The cause of over granulation is thought to be that some people are just inclined that way, just like some people get large 'keloid' scars from incisions or vaccinations. Plus the constant movement of the catheter against the mucous membrane irritates it and it tries to rid the body by growing more flesh against it. I think that some degree of skin infection can be a contributing factor also.

    i hope you have success with it


    I found more interesting suggestions here:
    http://www.tripanswers.org/Answer.aspx?qid=433

    And this from our own site dated 2002:
    http://sci.rutgers.edu/forum/showthread.php?t=3990

    Pictures and how to treat here:
    http://www.bcchildrens.ca/Services/S...tiontissue.htm

    All the best,
    GJ

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