Application of modified endotracheal tube in nursing of retracted stoma with severe moisture-associated skin damage: A case report.

RATIONALE: Severe stomal retraction often leads to peristomal moisture-associated skin damage (MASD), posing a significant challenge to conventional ostomy care, particularly for critically ill patients who are not candidates for surgical revision. To address this, we used an innovatively modified tracheal tube for fecal diversion. This approach not only effectively diverted fecal output but also prevented further skin exposure, thereby creating an environment conducive to healing MASD.

PATIENT CONCERNS: A 40-year-old male with metastatic colon cancer and a retracted colostomy developed a 3 cm × 3 cm refractory ulcer with persistent leakage despite standard care, causing significant pain and impaired quality of life.

DIAGNOSES: Severe peristomal ulceration with stoma retraction, metastatic colon adenocarcinoma, and critical complications including respiratory failure and pneumonia.

INTERVENTIONS: A modified endotracheal tube was used for fecal diversion. The tube was customized by truncating the distal end and sealing the lumen, then inserted and secured via cuff inflation. Complementary care included topical wound management and dietary control to maintain semiliquid stool.

OUTCOMES: The peristomal ulcer achieved complete epithelialization within 10 days. The patient reported substantial alleviation of discomfort and high satisfaction with the treatment, and nursing efficiency improved without complications.

LESSONS: This technique offers a simple, cost-effective, and nonsurgical option for fecal diversion in complex stoma-related MASD, especially valuable in critical or resource-limited settings, though ongoing monitoring is essential to prevent tube obstruction.