摘要
Management of surgically placed ostomies is an important aspect of any general surgical or colon and rectal surgery practice. Complications with surgically placed ostomies are common and their causes are multifactorial. Parastomal ulceration, although rare, is a particularly difficult management problem. We conducted a literature search using MD Consult, Science Direct, OVID, Medline, and Cochrane Databases to review the causes and management options of parastomal ulceration. Both the etiology and treatments are varied. Different physicians and ostomy specialists have used a large array of methods to manage parastomal ulcers; these including local wound care; steroid creams; systemic steroids; and, when conservative measures fail, surgery. Most patients with parastomal ulcers who do not have associated IBD or peristomal pyoderma gangrenosum （PPG） often respond quickly to local wound care and conservative management. Patients with PPG, IBD, or other systemic causes of their ulceration need both systemic and local care and are more likely to need long term treatment and possibly surgical revision of the ostomy. The treatment is complicated, but improved with the help of ostomy specialists.
通过手术放的 ostomies 的管理是外科的任何将军或冒号和直肠的外科实践的一个重要方面。有通过手术放的 ostomies 的复杂并发症是普通的，他们的原因是多因素的。Parastomal 溃疡稀罕，是一个特别地困难的管理问题。我们进行了用 MD 的搜索请教的文学，科学指导，考察原因和 parastomal 溃疡的管理选择的奥维德， Medline，和 Cochrane 数据库。病原学和处理被改变。不同医生和 ostomy 专家使用了方法的一个大数组管理 parastomal 溃疡；这些包括的本地创伤照顾；类固醇乳脂；全身的类固醇；并且当保守措施失败时，外科。没有的有 parastomal 溃疡的大多数病人联系了 IBD 或围口部的脓皮病 gangrenosum (PPG ) 经常对本地创伤照顾和保守管理快速作出回应。有 PPG， IBD，或他们全身、本地的溃疡需要的另外的全身的原因的病人关心并且是更可能的需要长期的治疗和 ostomy 的可能外科的修订。治疗是复杂的，但是在 ostomy 专家的帮助下改善。
