Infant with jejunostomy complications:  advantage combining an alcohol free paste, moldable barrier ring, and two-piece pouching system on a retracted stoma.

Male infant diagnosed with small bowel ischemia which required jejunostomy.  The mucosa sloughed off, exposing a retracted stoma.  The result was frequent pouch leakage and peristomal skin erosion.  An inadequate seal created both discomfort and distress for the patient.  The post-operative complications included a dehisced incision and fistula.

Alcohol free ostomy accessories eliminate pain associated with peristomal skin erosion.    

The non-alcoholic paste and moldable barrier ring did not hurt when applied to denuded skin.  The key to pouch adherence, was “caulking” both inside and under the wafer, with the alcohol free paste and moldable barrier ring.  Crusting over the paste with ostomy powder and alcohol free skin prep completed the durable seal. 

The one-piece pouch leaked three to four times a day.  The two-piece pouch maintained a 48 to 72 hours seal, when combined with an alcohol free paste and moldable barrier ring.  Nursing staff found the new pouching easy to replicate.   The patient's skin healed in three days.

1) Peristomal skin erosion       2)  Pouching procedure          3) Healed peistomal skin

     around jejunostomy