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Thread: Pressure ulcer / colostomy

  1. #1

    Pressure ulcer / colostomy

    Hi. I had a peri rectal abscess drained in March. That wound is almost healed but I developed a pressure sore in July. It's not deep but has a 4.5 cm tunnel. It's not tunneling towards the abscess. Right now we're trying a wound vac. A plastic surgeon suggested I think about a colostomy. I rarely have accidents and when I do it's cleaned up immediately. Since the abscess was drained I haven't done my BP on the commode to allow that wound to heal. I just wanted to know what other reasons besides accidents would a colostomy help prevent sores. Also what are some personal experiences/opinions with switching to a colostomy. Thanks.

    Tim

  2. #2
    I had the same surgery done, and developed a tunneled pressure ulcer in the open incision. Long story short, after 2 years of trying to close the wound w vac, I switched to a reconstructive surgery and had a flap done. In his practice he requires a colostomy and suprapubic done prior to a flap surgery. I had neither but he allowed me to have the surgery without, and it was, thankfully, successful. I think the reasoning is to avoid infection, but also bc the required laying flat etc after surgery make bowel programs a little more complicated. Your surgeon may be considering a flap surgery. I would advise you to seriously consider it. A 4.5 cm tunnel IS deep, and as KLD and others have emphasized, a stage 4 ulcer will not heal (successfully) without a flap. My two cents!

  3. #3
    Also some colostomies can be reversed, so that after a flap procedure, you can go back to previous method of bowel care.

  4. #4
    Thanks for your input. Yea I had a flap done on a previous wound. Opposite this one. It was successful. I have a suprapubic. I wonder how those who have had a colostomy feel about it versus doing a BP. Easier? Harder? Are they glad they did it?

  5. #5
    Senior Member
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    Quote Originally Posted by tfdowney View Post
    Thanks for your input. Yea I had a flap done on a previous wound. Opposite this one. It was successful. I have a suprapubic. I wonder how those who have had a colostomy feel about it versus doing a BP. Easier? Harder? Are they glad they did it?
    There is no comparison. I've had my colostomy for 3 years. For 24 years I did a 2-4 hour bp every other day. Now I do a simple 5 minute bag change when needed. My quality of life has improved so much. I have no limitations.

  6. #6
    Thanks. So are your movements predictable? Odor?

  7. #7
    I had a patient with the same presentation. All good information above. I agree that a colostomy would be in order.
    If you get a ostomy make sure you get an ostomy nurse who can educate and train you on all the details of managing one. That is the key to a successful ostomy placement
    pbr
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  8. #8
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    for me not really seems more like moring but its freedom total you learn ur body and ur need I never leave home with out extra and ways to change bagsbut its especially quad only way to go

  9. #9
    Senior Member
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    Quote Originally Posted by tfdowney View Post
    Thanks. So are your movements predictable? Odor?
    With a colostomy you go when your body is ready to go. That's what makes it so much better. I used to pace myself when eating knowing I always had to wait for bc days. Now I eat whatever I want, whenever I want with no worries. With the one piece system I have there is no odor. It has a built in filter. Also they have a deodorizing liquid you can put into the bag if ever needed. At first it will take a little time to get used to it and to find the right pouch system for you but after that you are good to go. I honestly wish I would have had it done 24 years ago.
    Last edited by HACKNSACK44; 09-04-2017 at 03:29 PM.

  10. #10
    Thanks for the advice. It's a big decision and wanted some feedback.

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