Purpose: This poster discusses the concept of skin safety in the ostomy patient and risk reduction for peristomal skin compromise. It describes peristomal skin as tissue at perpetual risk for compromise and discusses the role of convexity as a prevention and management strategy.

Objective: Skin safety is a term used in risk assessment and prevention of pressure ulcers and may be extrapolated to the ostomy patient as well. The goal of patient care is to provide safety and reduce the risk of complications. In the ostomy patient, healthy peristomal skin decreases complications and health care resource consumption while providing an increased sense of well being for the patient. Therefore, the maintenance of intact peristomal skin or early treatment of compromised skin is important.

Convexity in a pouching system contributes to an intact seal to provide a predictable, sustained wear time. It is a primary strategy for maintenance of skin integrity. While the relationship between abdominal muscle tone, appearance of the peristomal skin and type of convexity needed in pouching systems has been established, the concepts of skin safety and risk reduction may be new.

Outcomes: Maintaining intact peristomal skin frequently requires the use of convexity. Indications, uses and precautions when using convexity will be explored through a graphic presentation of case studies. An algorithm will be presented for decision-making and a variety of approaches for achieving convexity will be identified within the context of prevention and the maintenance of ostomy patient skin safety.

References:

Rolstad, B.S. & Boarini, J. (1996) Principles and techniques in the use of convexity. Ostomy Wound Management, 42,(1):24-34.

Wound, Ostomy, Continence Nurses Society. Convex Pouching Systems: A Fact Sheet for Clinicians. http://www.wocn.org/publications/

Wound, Ostomy, Continence Nurses Society. Convex Pouching Systems: A Fact Sheet for Patients. http://www.wocn.org/publications/