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STATEMENT OF PROBLEM:Ostomy pouching barriers have evolved over the decades. Original systems
incorporated glass and porcelain, followed by zinc based barriers. Modern hydrocolloid barriers were introduced in the 1970’s, giving way to most currently used pouching systems. Following broad principles of care such as the protection of the stoma and the peristomal skin, products were intended to not cause harm through their application, removal and day-to-day wear.
Unfortunately, recent literature has hightlighted the prevalence of peristomal complications; studies suggest that 16 to 74% of patients experience complication, and are frequently unaware of their skin condition.1-2 This suggests that current principles of ostomy care and available products are insufficient for meeting the goals of care, leaving room for product improvement.
Ostomy barriers are known to have an impact on peristomal skin. It has been reported that peristomal skin is impacted with barrier occlusion and barrier removal (skin stripping and increased transepidermal water loss).3,4 Ceramide is a type of skin lipid which helps protect against dryness. Most skin disorders that have diminished barrier function have changed in the total amount and pattern of ceramide present. 5
METHODS:Descriptive case studies/photo series includes patient history, initial treatment modalities, and the use of a ceramide-infused ostomy barrier.
CONCLUSION:The case studies presented demonstrate that a ceramide-infused ostomy barrier was useful in the management of peristomal skin issues. Larger case studies could be conducted to determine if a ceramide–infused barrier can have a more preventative effect, allowing ET nurses to consider reassessing their traditional care model of reacting to peristomal skin issues to a new model of preventing peristomal skin issues.
Financial Assistance Disclosure
The support of Hollister Incorporated for this clinical presentation is gratefully acknowledged.