Statement of Clinical Problem: A variety of stoma shapes and sizes are encountered during ostomy clinical practice.   A cut-to-fit skin barrier or a pre-cut skin barrier with accompanying accessory products may not meet patient self-care needs or desires.  Patients may experience problems, such as, improper cutting of a skin barrier, unpredictable wear-time, or the development of an allergic contact dermatitis to an accessory product or tape collar.

Description of Past Management:  

Three case study patients presented to our ostomy clinic with problems. The first patient presented with leakage issues, peristomal itching, difficulty cutting the skin barrier properly and dislike of using paste.  The second patient had peristomal scarring and uneven stomal topography and unpredictable wear-time using a pre-cut convex skin barrier with barrier ring. The third patient presented with peristomal dermatitis, and the need for simplified pouching technique.

 Current Clinical Approach:

All three patients were placed in the new flat moldable standard or extended-wear skin barriers without the use of pectin paste, barrier ring, or scissors.      

Outcomes:

The positive outcomes encountered with these case studies have confirmed that this barrier type is an innovative option for our ostomy patients. Key benefits include:

No scissors or template required

No mucosal injury from snug barrier

Ease of application and education

Predictable wear-time with secure fit

Skin protection from hydrocolloid collar

Less usage of pectin paste or barrier ring due to roll and mold technique. 

Conclusion:

The patients were satisfied with the benefits of this new product. The case study clinical experiences demonstrates that the flat moldable design simplified care and solved the problems that our patients were experiencing. The availability of these new flat moldable skin barriers has prompted an evaluation of how we currently practice ostomy care.

* SUR-FIT Natura® Moldable Stomahesive® or Durahesive® Skin Barrier

© 2007 E.R. Squibb & Sons, L.L.C.

SUR-FIT Natura, Stomahesive and Durahesive are registered trademarks of E.R. Squibb & Sons, L.L.C.                                                                                            US-07-2050

Case 1 showing moldable seal

without paste or use of scissors

Case 2 with peristomal skin

scarring and simplified pouching

Case 3 with peristomal allergic

contact dermatitis from paste