Taking a more proactive approach to maintaining healthy peristomal skin with a ceramide infused skin barrier

Objective: To evaluate the benefit of using ceramide infused skin barriers on patients with and without healthy peristomal skin. 

Significance: Literature demonstrates that as many as 70% of ostomy patients experience stoma related complications. Skin irritation, rash, and pouch leakage are the most common complaints.¹  Maintaining peristomal skin health is essential to maintaining quality of life.  Ceramide, a natural component in human skin; plays a critical role in maintaining skin health.²  Until now, clinicians have been able to choose from two categories of skin barriers: extended wear and standard wear.  Barrier selection is based on absorption and adhesion.³  A ceramide infused barrier is new technology that has provided WOC/ET nurses with an additional barrier option to help maintain healthy peristomal skin.

Method: Ceramide skin barriers were used on 7 patients; a combination of ileostomy and colostomy patients (6/7 followed for 7-14 days.  1/7 followed >30days).  All patients had a DET score between 2 and 7 at baseline. The DET tool scored patient’s skin integrity before and after use of the barrier.  Case studies and photos documented patient demographics, outcomes, and assessments.  Accessories such as paste and barrier rings were used when required to improve barrier fit.

Results: 7/7(100%) DET <2 at 7 days.  1/1(100%) DET 0 for 30 days. 

Conclusion: All patients who had peristomal skin breakdown and used the ceramide infused skin barrier showed improvement.  Patients who had healthy peristomal skin maintained healthy skin; DET <2. The positive outcomes from the use of this product suggest a change of practice from a reactive to proactive approach in terms of maintaining healthy peristomal skin.  More case studies are needed to determine the broader use of ceramide infused skin barriers and employing their use as a first choice for ostomy patients with healthy peristomal skin.