Open Colostomy Reversal

WHAT YOU SHOULD KNOW:

Open colostomy reversal is surgery to close your colostomy and reconnect your colon.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may bleed more than expected during or after your surgery. There is a chance your ureters, bladder, or bowels may be damaged during the surgery. Your caregiver may not be able to reconnect your colon. If this happens, you will need to keep your colostomy. After surgery, you may have fever, pain, nausea, or vomiting. You may get an infection of the skin and other tissue around your wounds. Your colon may leak or pull apart around the area where it was put back together. This can cause a serious infection.

  • Your intestines may become narrow or blocked after surgery. You could get a painful hernia, months or years after surgery. A hernia is a hole in the muscles of your abdomen letting your intestines push against your skin. You may need another surgery to fix these problems. You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs.

  • You are at risk for skin damage around your stoma. You may get an itchy rash, and your skin may become red, swollen, and sore.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Blood tests: You may need blood taken for tests to see how your body is working.

  • Medicines:

    • Antibiotics: This medicine helps prevent an infection caused by bacteria. You may get them before, during, or after your surgery.

    • Blood thinners help prevent blood clots. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise.

    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your surgery:

  • Your caregiver will make an incision in the middle of your abdomen and around your colostomy. He may cut along the same incision that was used when you received a colostomy. Your caregiver will cut away your colostomy from the skin. He will reconnect the cut ends to the rest of your colon with staples or stitches.

  • Your caregiver may put 1 or 2 drains under the skin near your surgery area. These drains may help your surgery wound heal. The drains will be removed when your wound stops draining fluid. The cut in the middle of your abdomen will be stitched or stapled closed. The area where your colostomy was may be stitched or stapled closed. The area may also be left open to heal. If it is left open, the area will be filled with gauze. Bandages will be placed on your wounds to keep them dry and to help prevent infection.

After your surgery:

You will be taken to a room to rest until you are fully awake. Caregivers will watch you closely for any problems. Do not get out of bed until your caregiver says it is okay. When your caregiver sees that you are okay, you will be taken to your hospital room. The bandage covering your incision helps keep it clean and dry to prevent infection. A caregiver may remove the bandage soon after surgery to check your wound.

  • Medicines:

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Pain medicine: Caregivers may give you medicine to take away or decrease your pain. Do not wait until the pain is severe to ask for your medicine. Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.

    • Laxatives: This medicine helps your bowel movements move through your intestines more easily.

  • Nasogastric tube: This is a flexible tube that is put into your nose during surgery. It is passed down your throat and into your stomach. The tube helps keep your stomach empty while your bowels start to work again after surgery. Food and medicine may be given through it until you can start to eat.

  • Foley catheter: This is a tube caregivers put into your bladder during surgery to drain your urine into a bag. Keep the bag below your waist. This will help prevent infection and other problems caused by urine flowing back into your bladder. Do not pull on the catheter, because this may cause pain and bleeding, and the catheter could come out. Keep the catheter tubing free of kinks so your urine will flow into the bag. Caregivers will remove the catheter as soon as possible, to help prevent infection.

  • Pressure stockings: These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots.

  • Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

  • Activity: Your caregiver may have you get out of bed and walk as soon as possible after surgery. This will help your bowels start working sooner. Call your caregiver before you get up for the first time. If you feel weak or dizzy when you stand up, sit or lie down right away, and press the call button.

  • Foods after surgery: Your caregiver will listen to your stomach for bowel sounds using a stethoscope. You may be able to eat when bowel sounds are heard. Tell your caregiver when you begin to pass gas and feel hungry after surgery. You may be given ice chips at first, and then liquids, such as water, broth, juice, or soft drinks. If you do not have problems after you drink liquids, caregivers may then give you soft foods. Some examples of soft foods are ice cream, applesauce, or custard. Once you can eat soft food easily, you may begin to eat normally.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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