Use of a Ceramide Infused Ostomy Skin Barrier in the Neonatal Intensive Care Unit

Patients in the neonatal intensive care unit (NICU) present with a range of needs and complexities for ostomy management. Pouching wear time may be impacted by factors including stool consistency, stomal fistulas and excoriation. A high frequency of pouch changes can adversely affect a baby’s quality of life and overall development. Leakage of effluent may increase the risk of wound complications. Products used on this patient population must be selected in consideration of the immature epidermal barrier and increased absorption of ingredients through the skin in topically applied products. A case series on three patients was undertaken to evaluate wear time and skin health using a ceramide infused skin barrier on neonatal patients with excoriated peristomal skin. Before introducing the new barrier wear times of 2-12 hours were being obtained on three neonates. Babyboy A had developed a fistula at the skin level, Babygirl B had deep skin creases and Babyboy C had high output and skin creases. Use of accessory products with neonatal ostomy barriers did not improve wear times. In consultation with the NICU pharmacist, the detailed ingredient list for a ceramide infused skin barrier was reviewed. Finding no known product ingredients of concern, approval was obtained to use this barrier. Pouching wear times increased from less than 12 hours to 3-7 days and peristomal excoriations were reduced or resolved for each baby. No adverse skin reactions were noted on the babies after use of the ceramide infused skin barrier. These cases indicate the use of a ceramide infused skin barrier in the overall care management plan increased barrier wear time and improved peristomal skin health. These case studies represent individual nurse/patient experience and are not intended to suggest all patients will obtain the same experience/results.