Proactive Management in Ostomy Care: Ceramide Infused Barrier Case Studies

Proactive Management in Ostomy Care: Ceramide Infused Barrier Case Studies

Authors:

Elizabeth Taggart BSN RN CWOCN

Ostomy Wound Services Memorial Medical Center

Springfield, IL

Karen Spencer BN ET

Director of Global Clinical Education Hollister Incorporated

Libertyville, IL

Statement of Clinical Problem: Maintaining peristomal skin integrity is a concern for ostomy patients. The literature suggests that as many as two thirds of people with an ostomy will develop a serious peristomal skin complication¹. Peristomal skin complications can impact health-related quality of life, health economics, and clinical outcomes.

Description of Past Management: All patients are exposed to PMASD, MARSI, and skin occlusion related to barrier use. Choosing the correct ostomy barrier is the responsibility of the WOC nurse to ensure a good seal around the stoma but also to minimize the impact that leakage, barrier removal and barrier occlusion has on the peristomal skin.

Current Clinical Approach: There are two categories of skin barriers: extended wear and regular wear; chosen based on absorption and adhesion ^2. To help maintain peristomal skin health, WOC nurses should consider new product options in their decision making to be more proactive in their practice.  

Selected Patient Outcomes:

The three cases include a urostomy, ileostomy and colostomy. In each case, the peristomal skin was ulcerated at the onset of care, and the ostomy management was modified to include use of a ceramide infused skin barrier.  Skin condition improved or resolved and in two cases, product utilization was reduced.

Conclusions:

WOC/ET nurses are challenged with managing peristomal skin complications and patients are negatively impacted.  Adopting ceramide infused skin barriers can help provide positive outcomes. Beyond case studies, further research is required to support this new product option.