How to Manage Ostomy Wafer Over Surgery Stitches?

Has anyone ever had surgery close to where your ostomy is? I am having gallbladder surgery on Friday, and my surgeon says where she placed my ostomy is really close to my gallbladder. So it stands to reason that she will be cutting me open in the general area of where my wafer goes. So I am wondering how I am going to wear a bag when the wafer would go over the stitches and sore where she cut into me. How this is going to play out is what I am wondering. I didn't think to ask her when I saw my surgeon. I am sure she will figure it out, and I will learn how to do it. I am just wondering and, yes, worrying about how this is all going to work out. She did tell me someone may have to "hold up" my ostomy while she goes in and snatches out my gallbladder. If that is the case, then yes, the stitches are going to be under my wafer. Someone tell me they had to do this and it worked out just fine. My ostomy is higher than where most people have theirs. It was relocated from a lower spot to the higher spot.

Lee

Have you discussed with your surgeon having your gallbladder removed laparoscopically vs. open surgery?

I'm just saying since open surgery requires more recovery time. I'm not a doctor, but perhaps it's an option for you. Best of luck with the procedure 🌈

I had my gallbladder and ostomy done at the same time... not by choice... and the edge of my wafer tape was and is right on the edge of where I was cut open. I didn't get stitches. I was left open to heal with a wound vac. I can send you pics if you want to see just how close it is.

Yes. She is going to try to do it without having to open me wide up, but she is doubtful that it will work out that way because of where my ostomy sits now.

Getting Support in the Ostomy Community with LeeAnne Hayden | Hollister

That would be interesting to see. If you don't mind, I mean. I am not sure what will happen with my surgery, but I do know that it's going to be close cutting. She told me someone will have to lift up my ostomy while she goes in to get the gallbladder. She did say she wished that she had known that I would need my gallbladder out when she did my relocation surgery because she would have done both at the same time. Unfortunately, we didn't know my gallbladder was not working at the time that I had the relocation surgery.

1st pic is 3 months after I had surgery and the wound finally closed and I had a one-piece... 2nd is how it is now 3.5 years later and changed to a two-piece. Where you can see how close to my stoma the edge of the wafer tape is (pink area 🤭)... once in a while it can get irritated even with barrier spray.
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I originally had staples after an infection. Two weeks later, they reopened me to finish cleaning out dead tissue and saw that they needed to do an emergency ostomy. In case you're wondering why the outside scar looks the way it does.
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My experience is the appliance won't adhere to a scar, don't know why, just doesn't. Discuss this thoroughly with the relevant experienced parties before proceeding.

I'm sure your surgeon isn't an idiot and will avoid causing issues if they can. I had staples under mine and have a tiny laparoscopic scar under mine now, no issues.

I too have a couple of laparoscopic scars that are covered. I have not seen any issues so far, but they are towards the outer edge of the flange, so maybe that is helping.

Good luck on your surgery. Hoping and praying for all the best for you.

Thanks everyone for the advice and words of encouragement. I think I am just trying to worry about something other than the surgery itself. I am nervous because she said it is likely she will have to open me wide up to be able to get the gallbladder without hurting my ostomy. She also has to do another surgery to fix my hernias because she said we can't leave them alone. But she can't do that surgery at the same time because she said the gallbladder isn't sterile. And I have to wait at least a month after my gallbladder surgery before she can open me up again. And that won't be a laparoscopic surgery.

Lee

Hi Lee,

So a couple of things to think about. First, let's assume your surgeon will have to make an incision in the same area that your barrier is located. An incision can heal under the barrier if it's not flooded with output, so no real issue there. You just have to make sure you don't have any leaks... or things can get ugly quickly. If it were me, I would call both the hospital's wound care nurse (or that department) and their ostomy nurse before the surgery and find out how they'll proceed to address your wound(s) post-surgery if the incision ends up partially under your barrier. Make sure they have a plan to address your wound post-surgery because it will be their problem, not the surgeon's.

Second, contact the manufacturer of your ostomy barriers and explain the situation. Tell them you're being asked to bring a number of barriers for your gallbladder surgery and they may have to be placed over a fresh incision. I'm pretty sure no ostomy supplies are sterilized, so have them tell you exactly what to do if their barrier needs to be placed over a wound. Is there something that should be put on the wound first... or what do they recommend? You may be able to find a physically smaller barrier that still fits your stoma but takes up less overall real estate. Regardless, if what they tell you doesn't jive with what the wound care and ostomy nurses have told you... you need to discuss with them again and come up with a new game plan... and a plan B. Same goes for if your barrier manufacturer flat out says do not place their barrier over an open wound... get on the horn and make sure both your wound care and ostomy nurse know that. There may be a sterile barrier made by someone for just such situations... but I don't know. But make sure you have a viable plan before you get operated on. I know... it's not your job to figure this out, but if you leave it up to them bad things might happen, and you'll have a date for an unspecified amount of time with the ICU.

Third... why didn't your docs know your gallbladder was going south when you were operated on previously? Gallbladders aren't fine one day and then totally screwed up the next. Your liver function results in your bloodwork should have shown elevated values, giving folks a heads-up things were not normal. And they require routine bloodwork be done before any operation, so I'm sure you had a workup done as pre-op for your relocation surgery. I'm a bit curious... why exactly do they say your gallbladder needs to be removed? Are you having the normal symptoms... fever, nausea, vomiting, indigestion, bloating, heartburn, gas, upper abdominal pain on your right side, yellowing of your eyes and skin (jaundice)?

;O)

Knife happy anyone?

Doctor-surgeon, sounds inexperienced.

Like Rose, I too had the GB removed at the same time...

I thought it's standard procedure?

And let me advise you that once the stoma is moved or touched or "held up," expect leaks.

It surprised me, the leaks—when I had Ken butt surgery until I asked my surgeon why daily leaks. Lap failed, so he opened me up. Not good recovery, not good anything. Just be prepared. I blew through my reserves—pouches, rings, mounting plates. Panic time, unprepared.

You got way too many surgeries planned, kiddo.

I didn't end up needing stitches; she glued me shut in all 5 spots she opened me up in. And my wafer does go over one of the spots, but it only halfway covers it. The belt I wear goes over the other half. Lol. It was a week ago today that I had the surgery. I am doing pretty good, still a little pain and lots of bruises where they tried to get an IV in.

Lee

Glad it wasn't as bad as you thought it would be... and you're doing OK ☺️

Glad to hear things went well! That's awesome.

😊