Stomal Retraction
Stomal Retraction
David Ray Velez, MD
Table of Contents
Definition
Stomal Retraction: Stoma Retracted ≥ 0.5 cm Below the Skin Surface
Incidence: 3-24%
Can Occur as Either an Early or Late Complication
Stomal Retraction 1
Risk Factors
Risk Factors
- Obesity
- Tension
- Short Mesentery
- Inadequate Mobilization
- Initial Stoma Height < 1 cm
- Postoperative Weight Gain
Complications
Can Cause Leakage and Poor Appliance Adherence with Peristomal Wound Issues/Infection
- Ileostomy May Be More Concerning Than Colostomy with Concern for High Output Leakage
Mucocutaneous Separation (MCS)
- Due to Increased Tension at the Mucocutaneous Junction
- *See Mucocutaneous Separation (MCS)
Stomal Stenosis/Stricture
- Due to Scarring as it Heals
- *See Stomal Stenosis/Stricture
Retraction Below the Level of the Fascia with Mucocutaneous Separation Creates a High Risk for Intraperitoneal Spillage and Peritonitis with Need for Immediate Surgical Revision
Management
Stays Above the Fascia: Local Wound Cares
- May Consider Surgical Revision if Nonoperative Management Fails to Provide a Secure Appliance Seal but Only if Improved Outcomes Can Be Expected
Retracted Below the Fascia: Surgical Revision
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)