- Hartmann’s Procedure
Surgical procedure named after Dr. Henri Albert Hartmann who first performed it in 1921. It is resection of the distal colon (rectosigmoid colon) with creation of a colostomy due to a complicated diverticulitis or acute left colonic complications. When performed as an emergency is considered life-saving. It consists in the surgical removal of a section of distal colon. The proximal (or top) end is brought out through the abdomen forming a colostomy and forcing the use of a colostomy bag to dispose of waste. The distal colonic end is oversewn and left inside. The procedure is normally temporary. There is a second surgery, a reversal, where the colon is swan back together restoring normal stool flow (continuity). At that point there is no more colostomy and no further need to use a colostomy bag. The Hartmann reversal carries major morbidity and mortality risks. With the advent of laparoscopy, these negative prospects have been reduced but remains a complex procedure. It is important to note that at times a reversal is not possible. Hartmann’s procedure is geared to weak patients where an immediate anastomosis is not warranted. For this same reason, a patient might not be apt for the second stage.
- High Output Stoma
It refers to a stoma that produces effluent beyond 750ml. From that point on there are increased chances for leakages.
- Hydrocolloid wafer
Also known as Hydrocolloid barrier, it surrounds the stoma and goes over the peristomal skin area. It is meant to keep the skin safe from continued adhesive use. A hydrocolloid wafer is made of water absorbents: gelatin, pectin, and fillers: sodium carboxymethylcellulose and polyisobutylene.