Rapid Healing of Peristomal Lesions with Modified Collagen and Sodium Polyacrylate

Statement of Clinical Problem

Peristomal skin lesions are are all too common and traditionally difficult to heal.  A review of the literature reports an incidence of up to 55% for the overall rate of peristomal skin complications.  In another study, the authors concluded that most patients living with a stoma will experience a peristomal skin compromise and require treatment in their lifetime.  Drainage from the peristomal lesions compromises barrier adherence.  Salves and a variety of dressings can further complicate the problem.  My case study aims at identifying an optimal treatment strategy for managing peristomal skin lesions.

Past Management

Prior management relied on crusting with ostomy powder and skin barriers for superficial lesions and soft, absorbant foams, hydrofibers and alginates for deeper lesions.  The use of these products failed to effectively manage exudate or prompt rapid healing.

Current Clinical Approach

A trial was initiated using a Modified Collagen powder in place of traditional ostomy powder for superficial lesions and for deeper lesions the Modified Collagen powder was topped with a sodium polyacrylate wound filler.

Patient Outcomes

The modified collagen powder initiated and controlled the inflammatory phase of healing to stimulate rapid would closure.  The sodium polyacrylate was able to conform to the shape of the ulceration and absorb exudate.  This facilitated moist wound healing for optimal closure.  Another benefit was decreased pain.

Conclusions

In this study, the use of modified collagen powder and sodium polyacrylate promoted faster healing and eliminated unnecessary pouch changes.