Incorporating advance wound care to restore skin health in patients with peristomal skin complications

Peristomal skin complications are a common occurrence for many patients with an ostomy.  They may impair adhesion of the pouching system, which in turn exacerbates the skin problem, potentially leading to further peristomal wounds. Patients with peristomal skin complications can have higher cost of post-surgical care than those who do not develop complications.¹  Usually, standard treatment and obtaining a proper fit manages the issue. However, when the “usual” does not help or there are severe skin complications the CWOCN needs more management options. Reportedly, nearly one million people in the United States and Canada will undergo ostomy surgery.² Despite pre-operative discussions on stoma site selection, allergy assessment, and type of ostomy appliance chosen, peristomal skin issues and wounds still occur in a number of ostomy patients.³ Many complications include but are not limited to pain, skin irritation, denudment, infection, and decreased appliance wear time. ⁴ Skin treatments often include ostomy paste, ostomy rings, powders, films, topical steroids, as well as assessment and reassessment of proper appliance fitting.  However, wound care dressings should also be considered. A collagen dressing with an intact extracellular matrix (CECM) can help provide protease modulation, support granulation tissue formation and re-epithelialization.  GV/MB PU antibacterial foam dressings can help reduce bioburden and manage moisture in the peristomal wound.  We will present 3 of our more difficult cases.  In each case, the patient had partial thickness wounds, with documented peristomal wounds both these dressings are reimbursed making it affordable for patients.  Our goal was restoration of pouch adhesion, rapid epithelization, and a return to quality of life for the patient.  Published literature shows that these advanced wound care products promote healing of a variety of wounds.  Utilizing these dressings for peristomal wounds under an ostomy appliance helped us to achieve our goal in a timelier manner.