When separation of the skin and MCJ is noted, what is the first action?

• A. Apply adhesive more securely
• B. Note location according to clock
• C. Notify provider
• D. Obtain measurements (length, width, depth)

Answer: (C)

When you see skin pulling away from the mucocutaneous junction around the stoma, the priority is to involve the provider promptly. This separation can signal a compromise of peristomal skin and seal, with risks such as tissue trauma, leakage, infection, or stomal issues. A clinician can assess for causes like stoma retraction, ischemia, or irritation, and guide immediate management to protect the skin and prevent further problems. They may adjust the barrier, add protective products, or change the appliance as needed.

In the meantime, avoid making changes on your own that could worsen the skin—keep the area clean and dry, and note any symptoms (pain, leakage, odor) to report to the provider.