Integrated Treatment by an Ostomy Care Team of a Complicated Mucocutaneous Separation After Radical Cystectomy With Ileal Conduit Urinary Diversion: A Case Report

Wound Manag Prev. 2020 Aug;66(8):22-25.

Abstract

An ileal conduit for urinary diversion after radical cystectomy is a common surgical procedure for muscle-invasive bladder cancer. Mucocutaneous separation, one of several potential complications following surgery, can cause life-threatening sepsis and may have long-term consequences such as stomal stenosis or retraction. However, there are few reports describing the treatment of mucocutaneous separation.

Purpose: The purpose of this case study was to report the outcome of a team-based, integrated conservative treatment of a 46-year-old patient with a complex mucocutaneous separation.

Case study: Abdominal distension, fever, and progressive oliguria developed in the patient 6 days after radical cystectomy and ileal conduit surgery. Gastrointestinal decompression, parenteral nutrition, urinary diversion, and antibiotic therapy were initiated. Fifteen (15) days postoperatively, peristomal ulcers and mucocutaneous separation were observed. After 16 days of treatment with hydrocolloid powder, a silver-containing hydrofiber dressing, and meticulous pouching techniques, the wounds were healed. No additional peristomal lesions developed or surgical procedures were required for repairing the stoma, and no adverse reactions were seen.

Conclusion: Comprehensive treatment provided by an ostomy care team facilitated the recovery and healing of a patient who had a complicated mucocutaneous separation of his urostomy.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cystectomy / adverse effects*
  • Cystectomy / methods
  • Humans
  • Male
  • Middle Aged
  • Oliguria / etiology
  • Oliguria / surgery
  • Postoperative Complications / surgery
  • Urinary Diversion / adverse effects*
  • Urinary Diversion / methods
  • Wound Healing