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  • To defunctionalize bowel.
  • Protection of distal anastomosis.
  • Relief of obstruction.

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Absolute

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  • None.

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Relative

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  • Carcinomatosis precluding mobilization of bowel.
  • Morbid obesity such that mesentery or stoma cannot reach the skin surface.

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  • The patient should be supine.

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  • Stoma may appear dusky with edema during the first postoperative week.
  • Enterostomal therapists can assist with patient education about appliance care as well as treatment of any peristomal skin irritation.

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  • Skin irritation from gastrointestinal contents.
  • Ostomy retraction (common in obese patients).
  • Mechanical obstruction due to an overly tight fascial closure around the stoma.
  • Parastomal hernia.
  • Prolapse.
  • Fistula.
  • Stenosis (may be treated with careful dilation).
  • Necrosis of the ostomy due to ischemia (requires reoperation for resection).

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