2 replies to this topic

[wheelysneakycat]

Hi,

I've had a suprapubic catheter for a year and 3 months, and this is the first time I've had this problem. A couple of weeks ago there was a sort of swelling on my skin near the stoma. At first it felt quite "spongey" to the touch, and apparently it looked red (I'm blind but my PA told me it was red). I just carried on washing it as normal (I don't usually have a dressing there except sometimes when the catheter is changed). After a few days it felt like it had turned into a sort of scab, at least there was crusty skin which got a bit sticky with the pus that normally comes out of the tube/stoma (I get a little pus, which I clean a few times a day). Then it seemed to disappear so I didn't do anything about it.

Then a couple of days ago a similar thing happened with the swelling. The next day the swelling went down and now it is very red and to the touch it feels like a cut. I wondered whether it was a boil before but I guess they wouldn't feel like a cut.

I had my catheter changed today and the nurse said she thought it was "over granulation". She put an NA dressing on it and I'm now waiting for the District Nurses to get in touch and come and look at it as the Continence Nurse who changes my catheter says the District Nurses are better for wound care. She said they will possibly use silver nitrate to deal with it, and in any case they need to keep an eye on it.

I am wondering if anyone here could explain to me what "over granulation" is? I asked her and she said something about this sometimes happening with wounds but I still don't understand what it actually means. From the little googling I've done I gather it's to do with the wound healing process but I wonder why this should suddenly start happening now? When I've already had the spc for over a year. Can certain things cause it to happen? Could it be a skin infection aggravating the area? I am wondering how I can prevent it in future if possible. I also wonder what silver nitrate is, the name sounds quite scary!

[gchesman]

Do you use silver nitrate?

[partygirl]

I have a SP catheter, mine has been in for 3 years, after about a year I also began having hyper granulation problems.
Mine has been treated a number of different ways over the past 2 years.

For a long time mine was treated with silver nitrate but I don't recommend that. The process is by touching the extra tissue with the tip of a 20cm stick that is coated in the silver nitrate which has a caustic affect on the damp mucous membrane ie it burns it. If you have sensation (which I fortunately don't) it stings like hell and some people find it too painful to proceed. The burnt flesh sloughs off the next day. There are also types of silver impregnated foam dressing squares that can be applied, I tried them but they didn't work on me.

I now have a system that is keeping over granulation under control and my stoma nice and clean. I apply a small dressing at home each morning that is a dab of an ointment called 'Kenacomb' right on the stoma entrance, cover with a 3cm square of a super absorbent foam dressing material, then some adhesive over the top to keep it in place. i think the ointment is by prescription only and is probably called something else in the UK, so this info may be of little use to you.

The cause of over granulation is thought to be that some people are just inclined that way, just like some people get large 'keloid' scars from incisions or vaccinations. Plus the constant movement of the catheter against the mucous membrane irritates it and it tries to rid the body by growing more flesh against it. I think that some degree of skin infection can be a contributing factor also.

i hope you have success with it