Effective Resolution of Postoperative Stoma Edema With Repeated Application of Topical 50% Glucose: A Case Report

Although glucose-induced osmotic gradients have been used to reduce intestinal edema, no standardized technique has been established. Repeated applications of this method have not been documented, and concerns remain regarding its potential effects on glycemic control. We present a case of a patient in his 20s admitted for treatment of an advanced pressure ulcer over the left greater trochanter. His medical history included spina bifida and type 2 diabetes mellitus. The ulcer was complicated by osteonecrosis of the left femur, and a left hip disarticulation was planned as a life-saving procedure. Before this procedure, a sigmoid colostomy was performed to divert the fecal stream. On postoperative day six following colostomy, the hip disarticulation was performed, and the patient's general condition gradually improved. However, persistent stoma edema was observed 12 days after surgery. Congestive discoloration of the stoma mucosa developed, and complications such as stomal outlet obstruction and abdominal distension were suspected. To address this complication, 20 mL of 50% glucose solution was applied topically to the intestinal mucosa eight times over five days. Following this treatment, a marked reduction in stomatal edema was observed. Notably, the procedure used in our case did not adversely affect perioperative glycemic control, suggesting its feasibility as a minimally invasive approach for managing acute-phase stoma edema.