Evaluation of a Cyanoacrylate Dressing to Treat Peristomal Irritant Dermatitis Under Ostomy Skin Barrier Wafers

Clinical Problem:  Peristomal irritant dermatitis (PID), often caused by ill-fitting wafers and subsequent effluent leaking under the appliance is a commonly reported problem.^1,2 Failure to adequately treat PID often results in severe erosion, bleeding, pain and increased healthcare costs related to supply use and provider visits.  While a number of interventions have been reported as successful¹, the use of cyanoacrylate to treat irritant dermatitis has received little attention.

 Methods:  Using a convenience sample, topical cyanoacrylate* dressing was applied to five patients with peristomal irritant dermatitis. Appropriate modifications to the ostomy appliance were initiated and the patients were instructed to self-apply a cyanoacrylate topical dressing to the PID at each wafer change. Patients were assessed for wound pain using a Likert Scale, time to healing and number of appliance changes. Patient satisfaction with this method of treatment was also examined. Results: Average reported pain levels of 9.5 at the initial PID assessment visit decreased to 3.5 at the first wafer change and were absent by the second wafer change. Wafer changes averaged 3.2 days with increasing length between changes by the second week of treatment. An average of 3.8 wafers were used until patients returned to their pre-PID wafer wear time. Epidermal resurfacing occurred within 10.2 days. Because of the skin sealant action of this dressing, immediate adherence of the wafer was reported at all wafer changes. Patients reported high satisfaction with this method of PID treatment due to reduced pain and immediate wafer adherence.

Conclusion: The use of cyanoacrylate dressings is a viable option to treat peristomal irritant dermatitis in conjunction with individualized wafer modifications as appropriate.  Further study on a large scale basis is warranted.

*Marathon Liquid Skin Protectant, Medline Industries, Mundelein, IL