The cause of irritant contact dermatitis in stoma patients

Purpose

The most common peristomal skin problems were related to contact with effluent. One of the risk factors for Skin problems is leakage. Thus, this study aims for the accommodation of patient’s faster adaptation by clarifying the causes of leakage and applying it to patient education.

Methods

Between January 2011 and December 2011, 580 patients who underwent various stoma operations in a medical center were included in this study.

This prospective study was utilized to describe stoma related problems seen by WOC nurse. After discharge, ongoing care was performed at the WOC nurses’ clinic within first 2 or 3 postoperative weeks, and then evaluated skin and pouching system for 3 month.

Results

There were 580 patients. The types of ostomies seen were 222 colostomies, 352 ileostomies, and 6 jejunostomies. The total numbers of complications were 78 patients (13.4%) out of 580 patients. The types were divided into peristomal and stomal complications: peristomal complications include irritant contact dermatitis(48), pseudoverrucous lesions(2), peristomal varices(1), and allergic contact dermatitis(1); stomal complications were mucocutaneous separation(19), prolapsed stoma(4), and laceration(3).

 Irritant contact dermatitis was the most common type of peristomal skin complication (48) patients; 30 ileostomates and 18 colostomates) and was caused by stool leakage (32) or usage of inappropriate pouching system (16).

 Stool leakage onto the peristomal skin was caused by collapsed pouch(28), or too small cut hole on wafer flange(3) or changed abdominal contour(1).

Another problems were arose by use of inappropriate pouching system i.e. too large cut hole (16).

 Conclusion

The most common reason of pouch leaking is pouch collapse and it can also occur when distal loop of loop stoma is covered under the base plate. WOC nurses' roles are preventing these problems, improving stoma, moreover, improving ostomy patients' quality of life.