Mucocutaneous Separation (MCS)
Mucocutaneous Separation (MCS)
David Ray Velez, MD
Table of Contents
Definition
Mucocutaneous Separation: Ostomy Separation from the Peristomal Skin
- Separation Can Be Either Partial or Circumferential/Complete
Incidence: 3-25%
Generally Considered an Early Complication within the First 1-2 Weeks
Mucocutaneous Separation 1
Risk Factors
Risk Factors
- Obesity
- Tension
- Local Ischemia/Inadequate Blood Supply
- High-Output Stoma
- Infection
- Malnutrition
Complications
Can Cause Leakage and Poor Appliance Adherence with Peristomal Wound Issues/Infection
Stomal Stenosis/Stricture
- Due to Scarring as it Heals
- *See Stomal Stenosis/Stricture
Stomal Retraction
Mucocutaneous Separation with Retraction Below the Level of the Fascia Creates a High Risk for Intraperitoneal Spillage and Peritonitis with Need for Immediate Surgical Revision
Management
The Majority are Managed by Local Wound Cares
- Fill Defects with Absorptive Material Such as Skin Barrier Powder, Calcium Alginate, or Hydrofiber/Gelling Fiber Before Pouch is Applied
Surgical Revision is Rarely Required – Primarily Considered if Indicated for Stomal Retraction
References
- Rodrigues FP, Vieira Novaes JA, Pinheiro MM, Martins P, Cunha-Melo JR. Intestinal Ostomy Complications and Care. Intech Open. 2019. (License: CC BY-3.0)