Nursing Intervention in Stomal and Peristomal Complications: Case Study

INTRODUCTION:  Stomal and peristomal complications in adults result of clinical condition, treatment and absence of preoperative stoma site marking, compromising rehabilitation. CLINICAL PROBLEM: Case Study 3 patients, not stoma site marked with complications of stoma and peristomal postoperative, with difficulties in adaptation of Pouching system and were attended by WOC Nurse. Case 1: 75, female, with  Mucocutaneous separation, Peristomal irritant contact dermatitis, pain and 3 daily changes of Pouching system in ileostomy from metastatic colorectal cancer. Case 2: 68, male, Peristomal irritant contact dermatitis and pain, with more than 2 daily changes of colostomy Pouching system by chagas megacolon. Case 3: 45, female, with Peristomal irritant contact dermatitis and pain, with more than 4 daily changes of Pouching system in ileostomy from colorectal cancer. INTERVENTION: We used hydrofiber dressing with silver, paste and protective skin barrier during 1 month with the use of pre-cut convexity Pouching system and belt (cases 1, 2 and 3), with teaching self-care (stoma and Pouching system) for the patient and family by WOC Nurse. RESULTS: There was complete healing of Mucocutaneous separation, Peristomal irritant contact dermatitis and improve pain in three weeks, with Pouch changes every 4 days (case 1), every 5 days (case 2 and 3). CONCLUSIONS: The specialized educative intervention from WOC Nurse with indication of Pouching system for the patient, use of hydrofiber dressing with silver and paste resulted in wound healing, self-care learning and resumption of daily activities for patients and families.