A Novel Approach to the Effective Management of a Non-healing Peristomal Wound

Problem: Peristomal wounds are challenging to patients and clinicians due to heavy exudates interfering with effective pouching systems. This becomes more challenging when the effluent is liquid. Patients experience skin damage, increased financial burden, depression and social isolation associated with pouch failures and leakage.

Rationale: A new super absorbent polymer hydrogel colloidal sheet dressing has the ability to provide moist wound healing while absorbing the wound exudates. The flat nature of the dressing provides a pouching surface which will allow an ostomy appliance to be adhered to the dressing.

Method: A pictorial case study of a 78 y.o. female with a poorly constructed ileal conduit due to Bladder CA. Her condition was complicated by NIDDM, COPD, ASHD, metastatic disease and development of a non-healing peristomal wound. Pouching was further complicated by a peristomal hernia. The wound was slow to heal due to chemotherapy to treat the Cancer. The wound was dressed with a super absorbent hydrogel colloidal sheet dressing then the ostomy was pouched as usual, a hernia belt was utilized. The wound did close after beginning this therapy for about a month and then reopened, since this time we have been able to reduce wound size from 1.5 x 2 x 0.2 cm to less than 1 x 1 x 0 cm and free of eschar, slough or infection. Patient obtained appliance wear times of 3 to 5 days.  

Conclusion: The super absorbent polymer hydrogel colloidal sheet dressing was effective in managing the wound exudates, allowing for treatments such as debridement, infection prevention and provided a dry surface to apply the ostomy pouch. The dressing provided protection and a moist wound healing environment and the wound improved despite ongoing disease progression. The patient returned to her normal activities and enjoyed a cost effective ostomy/wound management system