Mucocutaneous separation is the detachment of the stomal tissue from the surrounding skin and can occur from a surgical site infection, tension on the suture line and performance of the surgery on a patient who has poor healing potential. This can occur as soon as 24 hours after surgery.
- Suture line tension
- Patient has poor healing potential
Identification and assessment:
To visualize the peristomal area, gently remove the pouching system and cleanse the area with warm water using a soft washcloth.
Gently, using a cotton tip applicator, assess any open areas around the stoma exit site for depth. Be aware that it may be circumferential.
Promote healing and prevent fecal contamination, stenosis and/or stomal retraction. If this is detected in the immediate post-operative period, the surgeon should be notified.
Wound care to the separation should address depth and degree of separation using an absorbent filler dressing to promote granulation tissue in the areas of separation. Once that is addressed, use techniques to support a dry pouching surface and protect the open areas from fecal contamination.