Using a moldable skin barrier* to manage a prolapsed stoma

Prolapsed stomas are a recognized complication in ostomy care. More common in transverse colostomies (38.5%), it is also a phenomenon in ileostomies (6.8%) and in end colostomies or ileal conduits (4%) (Colwell et al, 2004).  The management of prolapsed stomas is a challenge in clinical practice: mobile prolapses require alterations in the appliance aperture, the rigidity of traditional barriers can cause damage to the mucosal surface, and maintaining patient independence in care may be compromised because of the stomal alterations.  Ideally, an ostomy skin barrier would continue to maintain the principles of ostomy care (prevention of trauma to the stoma and skin) while facilitating ease of care for the patient.

Prolapsed stomas can be mobile, rendering differences in flange sizing. Sizing issues can lead to exposure of the peristomal skin and potential complications.  The construction of traditional cut-to-fit skin barriers is problematic for prolapsed stomas:  the thin plastic coating welded to the barrier can cause lacerations and mucosal trauma.

The introduction of a moldable skin barrier may enhance care.  The rebound capacity of the moldable barrier offers the ability for a secure fit, while preventing mucosal compromise and peristomal skin complications, maintaining patient self-care abilities.

This poster will review a case of a prolapsed stoma that successfully illustrates how a moldable skin barrier provided protection for the stoma and peristomal skin, and easier management for the patient. *ConvaTec Moldable TechnologyÔ Skin Barriers. ConvaTec Moldable Technology is a trademark of ConvaTec Inc.