Peristomal skin health and improved quality of life

Statement of Clinical Problem

Peristomal skin complications (PSC’s) are a problem for up to 74% of people (Richbourg L, Thorpe JM & Rapp CG, 2007). Quality of life (QOL) scores are greatly reduced in the presence of PSCs.  (Rosenbaum, 2012). It is widely understood that a PSC is associated with an increase in health care costs. In the United Kingdom accessory usage costs up to £74 Million, some of which are used to manage PSCs.  (Health & Social Care Information Centre, 2016).

Hydrocolloid barriers were introduced in the 1970’s and are expected to adhere to the skin, absorb moisture and resist erosion while protecting the peristomal skin. Today, we have a selection of infused skin barriers aimed at maintaining skin health and include Manuka Honey, Aloe Vera and Ceramide.

Method

Three case studies will be presented involving PSCs: two PMASD and one MARSI. .These are common type of complications seen in our practice and diagnosed during the current pathway of hospital review three months post-surgery.  Peristomal skin was assessed using the DET scoring tool and QOL was assessed using the GAD7 (Generalized Anxiety Disorder) and PHQ9 (Patient Health Questionnaire) validated scoring tools.  At time of first review an  infused barrier became part of the overall care. Each person was followed up at one week and again at three weeks and consisted of a peristomal skin assessment, QOL assessment and photographs.

Results

We found that as skin health improved there was an associated improvement in quality of life.

Conclusion

All health care professionals should have a greater understanding of the relationship between peristomal skin health and quality of life. Such information may impact how clinicians can be more proactive in their practice to prevent and maintain skin health, including barrier choice.