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This chapter is about a “perfect storm” of stoma dysfunction. The first thing you see in the illustration is the terrible skin erosion around the stoma. The skin protective barrier is not able to protect the skin around the bowel at all. This is because the stoma has retracted and is functioning below skin level, and the bowel involved is the jejunum and therefore the stool is copious and liquid. Even using every trick in the stoma therapists’ book, the succus escapes under the barrier, burns the skin, and encourages the barrier to lift. The pH of the jejunal effluent ranges from 4.7 to 5.9, depending on the relationship of when it’s measured to the last meal, so jejunal content can certainly cause a chemical burn to the skin. Here a method of dealing with a dysfunctional jejunostomy is described.

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What Sort of Trouble Do You Think the Patient Had, and What Would You Recommend Be Done About It?

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  • 发表日期：

    2025年

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  • James M. Church

摘要

This chapter is about a “perfect storm” of stoma dysfunction. The first thing you see in the illustration is the terrible skin erosion around the stoma. The skin protective barrier is not able to protect the skin around the bowel at all. This is because the stoma has retracted and is functioning below skin level, and the bowel involved is the jejunum and therefore the stool is copious and liquid. Even using every trick in the stoma therapists’ book, the succus escapes under the barrier, burns the skin, and encourages the barrier to lift. The pH of the jejunal effluent ranges from 4.7 to 5.9, depending on the relationship of when it’s measured to the last meal, so jejunal content can certainly cause a chemical burn to the skin. Here a method of dealing with a dysfunctional jejunostomy is described.