INTRODUCTION: Stoma and peristomal complications in adults result from clinical condition, treatment and absence of preoperative stoma site marking, compromising patient’s rehabilitation. CLINICAL PROBLEM: case study with 4 patients, where the site has not been marked preoperatively, resulting in or and complications of stoma and peristomal postoperative, difficulties in adaptation of pouching system and were attended posteriorly by a WOC nurse. case 1: 73 years old, female, with mucocutaneous separation, peristomal irritant contact dermatitis, ulcers wound, pain and 3 daily changes of pouching system in ileostomy from metastatic colorectal cancer. case 2: 76 years old, male, with mucocutaneous separation, peristomal irritant contact dermatitis and pain, with more than 2 daily changes of colostomy pouching system by chagas megacolon. case 3: 45 years old, female, with peristomal irritant contact dermatitis and pain, with more than 4 daily changes of pouching system in ileostomy from colorectal cancer. case 4: 84 years old, male, with mucocutaneous separation in colostomy by chagas megacolon and lack of knowlegde about the self-care. INTERVENTION: use of hydrofiber dressing with silver, paste and protective skin barrier during 1 month with pre-cut convexity pouching system and belt (cases 1, 2 and 3). In case 4 the pouching system was flat and cut out, with teaching self-care (stoma and pouching system) for the patient and family by a WOC nurse. RESULTS: there were complete healing of mucocutaneous separation, peristomal irritant contact dermatitis and improve of pain in three weeks, with pouch changes every 4 days (case 1), every 5 days (case 2 and 3) and every 7 days (case 4). CONCLUSIONS: the specialized educative intervention from a WOC nurse, indicating the pouching system for the patient, the use of hydrofiber dressing with silver and paste resulted in wound healing, self-care learning and resumption of daily activities for patients and families.
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