I just finished changing my appliance with my home nurse, and if I was uncertain last time, there’s no doubt now: My stoma incision wound is healing! The left side is nearly closed with healthy pink skin. The right side still has a long way to go, and remains quite painful, but it too is noticeably improved from even a few days ago. My nurse was surprised at the rate of healing, which I’m pretty sure is the first pleasant surprise I’ve had since June. In other good news, there was again no sign of leakage and skin immediately surrounding the stoma showed no signs of irritation or degradation. I don’t want to jinx anything, but if the last few weeks are any indication, my stoma should be fairly manageable once the surrounding wound heals. All good.
In case anyone else out there is struggling with stoma wound healing, here’s a quick rundown of what we’ve done (and what’s seemed to work so far). The challenge in healing an open wound around a stoma is twofold: (1) keeping it dry, and (2) keeping it clean. To keep it dry, we’ve tried two strategies. First, we’ve used a hair dryer and absorbent gauze during appliance changes before liberally applying stoma powder to all areas of the wound. The stoma power absorbs moisture, allowing the wound to heal. We also applied some silver nitrate powder to prevent infection. To keep it clean, we’ve used no-sting barrier spray and stoma paste, again quite liberally. After applying the powder and spray, we spread a layer of stoma paste over the entirety of the wound (in addition to applying it to the appliance wafer). We’ve used this strategy for a couple weeks now, and it seems to have worked fairly well.
Today, we tried something new: calcium alginate wound dressing. After applying a little silver nitrate, stoma powder, and barrier spray, we placed a calcium alginate dressing in the wound. Calcium alginate is a cotton-like substance derived from seaweed, which is extremely absorbent and should absorb all moisture in and around the wound. As it absorbs moisture, it will turn into a gel-like substance covering the wound. We sealed in the calcium alginate with a strip of Tegaderm Dressing and then applied the stoma appliance as usual. We’ll see what it looks like on Saturday and either continue this strategy or go back to the simpler stoma powder/paste solution.
Regardless, any day with positive progress is a good day.