A new approach in preventing peristomal and perifistular skin breakdown utilizing silicone technology

Introduction:  The case series involved two ostomy patients and one fistula patient receiving nursing care from a community home health care agency. The goal was to evaluate the ease of application, the effectiveness of silicone as a barrier from effluent leakage, as well as the ease of removal while minimizing peristomal/perifistular skin damage.

Method:  The new silicone technology was utilized in a barrier ring and a silicone gel. Three patients were selected, all three with mild to moderate peristomal/perifistular skin breakdown. All three patients were seen initially for assessment, photos and initial application of silicone rings and gel, while continuing to utilize their current brand of barrier and pouch.

Results: All three patients showed significant improvement after three days of uninterrupted appliance wear time, and were completely free of peristomal/perifistular skin breakdown by week two.  All three noted an immediate decrease in the pain with appliance removal when utilizing silicone technology versus traditional hydrocolloid barriers and pastes.

Conclusion:  New, advanced silicone ostomy accessories have shown in this case series not only to have maintained intact peristomal/perifistular skin, but have also shown to be beneficial in reversing the damage caused by effluent leakage under the barrier. Patients also appreciated not having to change their current brand of barrier and pouch to utilize the new silicone technology. The three patients were able to return to a lifestyle comparable to their previous state, each stating that they are less concerned about barrier leakage with the new silicone ostomy accessories.