I have an ulcerative looking sore (approx. 1 inch diameter) next to my stoma which I’ve had for months and I cannot get it to heal. It is extremely painful to the touch and bleeds easily. It is irregularly shaped. I have tried the stoma powder, fungal powder and my doctor has even injected it with anti-inflammatories. We have a stoma nurse but she has no clue as to what it is. Any suggestions?
Without seeing the ulcer it is hard to give you a definitive answer.
Peristomal ulceration can occur for many reasons.
However if you have had a history of inflammatory bowel disease – the pain and irregular shape of the ulcer that you describe may be due to pyoderma gangrenosum. This is a painful ulcerating skin condition which can occur around the stoma. Another distinguishing factor is that the ulcer usually has a blue tinge around the ulcerating edges.
The treatment for this is different to any other ulcer and you may need referred to a dermatologist or colorectal doctor as it involves potent steroid creams, dressings and close follow up – but if diagnosed can be treated.
Please come back to me if you need any more advice.
I have a similar problem with 2 ulcers very close to the stoma. I am trying various products and techniques and I thought that maybe we could share things as we go along. My last ulcer took almost a year to heal. Last time, my nurse gave me Alginate dressing to absorb exudate from the wound. We then used a clear dressing (Tegaderm) to cover. The wound then became hypergranulated (tiny red bumps that bleed easily.) We then had to use silver nitrate to control that. Ultimately, Medihoney hydrocolloid dressing (it’s actual manuka honey) healed the ulcer.
Currently, I am trying silver alginate dressing covered by extra thin duoderm (hydrocolloid dressing). I then place a ring of eakin seal around the opening of the wafer for extra leakage protection. I will let you know how this works out. My mistake in the past was that I did not change the bag at the first sign of seal failure (itching, burning). My plan is to switch over to medihoney once the weeping/bleeding slows down.
Are you in the USA? UK? I’m in the US and thinking these products may have different names there.
Is there another stoma nurse in your area? Perhaps a second opinion would be helpful.
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