A Last Resort: Dacron Vascular Graft Prosthesis for Management of a Blowhole Colostomy.

This article focuses on the use of a Hemashield Gold Dacron Graft to improve management of a blowhole colostomy in a patient with large bowel obstruction due to metastatic carcinoid tumor. Blowhole colostomies, originally described as emergency treatment for toxic megacolon, can be challenging to manage because of poor appliance fitting, peristomal dermatitis, and pain. Building on a 2021 Brazilian case series that used a Dacron Vascular Prosthesis sutured to the mucocutaneous junction, this case study describes modifications including a shorter graft length, use of non-absorbable Nylon sutures, and horizontal mattress stitches with larger bites to enhance graft stability and patient quality of life. Although long-term follow-up was limited by the patient’s death, the technique demonstrated potential as a palliative option for complex colostomy management when other interventions are not feasible.