Prolapse Prolapse is seen most frequently with loop colostomy as this is often a temporizing procedure, the prolapse can be managed with reduction and supportive care until definitive surgery is planned. If the prolapse persists and disrupts pouching or is otherwise symptomatic, revision is indicated. Consideration should be made to convert the loop to an endo-colostomy and mucus fistula if the primary pathology can not be resolved. Factors that predispose to development of hernia include stoma placement lateral to the rectus, a large stoma aperture, obesity, prior abdominal incisions, malnutrition and would infection. Minor cases may respond to conservative management with abdominal binders, but symptomatic cases will require repair.
Relocation is the preferred method for correction if the patient is able to tolerate a laparotomy.
Many local procedures have been described and are useful in some settings. Skin Complications Contact dermatitis is the most common disorder associated with stomas. This can result from allergic reactions to components of the ostomy appliance or, more frequently, exposure of peristomal skin to ostomy effluent. Erosion of the skin can result in prolonged and repeated exposure of stoma content which in turn hinders appliance placement and sets up a vicious cycle of leaks and progressive skin irritation. Breaking this cycle with improved cleansing of peristomal skin, application of descents or steroids, use of skin barriers, antifungals and occasionally antibiotics improve appliance fit and eventually diminish leaking and continued irritation.