An overview of stoma care accessory products for protecting peristomal skin

Fiona Le Ber answers some of the questions that stoma care nurses may have regarding this novel silicone adhesive based technology, which helps to avoid medical adhesive related skin injury (MARSI) and moisture-associated skin damage (MASD). Whereas hydrocolloid stoma appliances absorb moisture, this has a non-absorptive method of moisture management that prevents peristomal skin becoming damp and excoriated.

Download Full-text

Using a novel breathable silicone adhesive (Sil2™ technology) in stoma appliances to improve peristomal skin health: answering the key questions

British Journal of Nursing ◽

10.12968/bjon.2020.29.16.s16 ◽

2020 ◽

Vol 29 (16) ◽

pp. S16-S21

Author(s):

Fiona Le Ber

Keyword(s):

Skin Damage ◽

Skin Injury ◽

Moisture Management ◽

Silicone Adhesive ◽

Peristomal Skin ◽

Medical Adhesive ◽

Key Questions ◽

Stoma Care

Fiona Le Ber answers some of the questions that stoma care nurses may have regarding this novel silicone adhesive based technology, which helps to avoid medical adhesive related skin injury (MARSI) and moisture-associated skin damage (MASD). Whereas hydrocolloid stoma appliances absorb moisture, this has a non-absorptive method of moisture management that prevents peristomal skin becoming damp and excoriated

Download Full-text

Use of Betel Leaves in Pediatric Stoma Care

Journal of Paediatric Surgeons of Bangladesh ◽

10.3329/jpsb.v1i2.19534 ◽

2014 ◽

Vol 1 (2) ◽

pp. 148-152

Author(s):

Md. Ashraf Ul Huq ◽

A K M Mizanur Rahman ◽

Tahmina Hossain

Keyword(s):

Zinc Oxide ◽

Cost Effective ◽

College Hospital ◽

Mucosal Ulceration ◽

Medical College ◽

Betel Leaf ◽

Number Of Patients ◽

Peristomal Skin ◽

Two Parameters ◽

Stoma Care

Background: To find out a practicable, cost effective and easily available alternative of commercial stoma care devices for pediatric patients in a developing country.Methods: The study was conducted in the department of Pediatric Surgery in Dhaka Medical College Hospital, Bangladesh, during two years period from May 2009 to April 2011. Number of patients was 162 with age range 2 days to 7 years, mean age 2.3 years. As early as a colostomy or ileostomy had started functioning, a central hole was made in a betel leaf. The hole could just snugly accommodate the stoma. After applying a layer of zinc oxide paste over the peristomal skin the leaf was placed as such the stoma rotrudes through the hole. The smooth shiny surface of the leaf would face upwards and rough surface downwards. Another intact betel leaf with the shiny surface also facing upwards would cover the stoma. The leaves did not act as a reservoir rather simply acted as a barrier between the effluent and the peristomal skin. Fifty seven patients with colostomy and 11 with leostomy used stoma appliances (wafer with bag). Eighty six patients with colostomy and 8 patients with ileostomy used betel leaves and zinc oxide paste. Mean length of time between creation and closure of a colostomy was 9 months and that of an ileostomy was three months. It was ensured that each individual patient had used his or her respective stoma care method till closure of the stomas. Two parameters were used to evaluate the outcome of the above mentioned stoma care methods: (a) peristomal skin excoriation and (b) insultto the stomal mucosa in the form of ulceration.Results: Among the patients who used stoma appliances 21.53% developed peristomal skin excoriation, 7.69% developed mucosal ulceration and 6.34% patients developed local hypersensitivity reaction to stoma adhesive. On the contrary, patients who were managed with betel leaves 20.93% developed peristomal skin excoriation and 8.13% developed mucosal ulceration. No incidence of allergic reaction to local application of betel leaf and zinc oxide occurred. Average cost for betel leaves was less than 0.50 US$ per month in comparison to about 30 US$ for ostomy appliances.Conclusion: Betel leaves may be used as a cheap, easily available, non irritant and effective alternative of commercial appliances to protect the stomas and peristomal skin in pediatric patients.DOI: http://dx.doi.org/10.3329/jpsb.v1i2.19534

Download Full-text

Preventing prescribing of antibiotics for peristomal moisture-associated skin damage (P-MASD)

Gastrointestinal Nursing ◽

10.12968/gasn.2020.18.7.18 ◽

2020 ◽

Vol 18 (7) ◽

pp. 18-26

Author(s):

Sharon Colman

Keyword(s):

Bacterial Resistance ◽

Clinical Nurse Specialist ◽

Nurse Specialist ◽

Skin Damage ◽

Topical Antibiotic ◽

Clinical Nurse ◽

Appropriate Treatment ◽

Peristomal Skin ◽

Selection Of ◽

Stoma Care

People living with a stoma may, at some point in their stoma journey, experience peristomal skin complications (PSCs). The majority of PSCs occur as a result of leakage of stomal output onto the peristomal skin, which often results from poor templating or selection of stoma appliance. PSCs typically manifest as hot, red, sore and weepy skin. The symptoms can be misinterpreted as signs of infection, and, as a consequence, professionals may incorrectly prescribe a systemic or topical antibiotic. This is especially problematic, as overuse of antibiotics has been leading to greater bacterial resistance to these treatments, and it is increasingly emphasised that they should not be prescribed unless absolutely necessary. However, an experienced clinical nurse specialist in stoma care should be able to correctly diagnose a PSC, prescribe the appropriate treatment and resolved the problem quickly, without the use of antibiotics.

Download Full-text

Knowledge and Practice of Stoma Care among Ostomates at B.P.Koirala Memorial Cancer Hospital

Journal of Nobel Medical College ◽

10.3126/jonmc.v4i1.13302 ◽

2015 ◽

Vol 4 (1) ◽

pp. 36-45 ◽

Cited By ~ 2

Author(s):

Radha Acharya Pandey ◽

Sandhya Baral ◽

Govinda Dhungana

Keyword(s):

Skin Irritation ◽

Self Care ◽

Care Practice ◽

Psychomotor Skills ◽

Permanent Colostomy ◽

Cross Sectional ◽

Significant Difference ◽

Peristomal Skin ◽

Knowledge And Practice ◽

Stoma Care

Background: There are more than 1 million patients with a permanent colostomy and the number is increasing by the rate of 100 000 per year. Clients with a new stoma must master multiple psychomotor skills to remove their pouch, clean the stoma and peristomal skin and empty and dispose of effluent from the pouch. Stoma care self-efficacy has been positively related to ostomy adjustment.Objective: To assess knowledge and practice of stoma care among ostomates.Method: This is a simple descriptive cross sectional study. A total of 94 ostomates who met eligible criteria were purposively sampled. Stoma self care efficacy scale and semi-structured questionnaire was used and face to face interview was done. Data were analyzed using SPSS version 16 program. T test was used to see the mean difference.Result: The knowledge of ostomates on normal stoma and complication of stoma was adequate (61.7%). Majority (92.6%) respondents had good daily care practice like emptying pouch, hand washing before and after procedure and cleaning stoma. Majority of the ostomates suffered from physical problem (89.4%). Of which maximum 72.3% had peristomal skin irritation, then came leakage and odour. More than half (64.9%) of ostomates had higher efficacy.Conclusion: On the basis of findings, it is concluded that there was significant difference in mean knowledge of ostomates with variables pre-operative teaching, training on stoma care, living with stoma for more than 12 months. There was significant difference in mean self care efficacy with variables duration of living with stoma and training on stoma care. Thus training on stoma care should be provided frequently to further improve self care efficacy.Journal of Nobel College of Medicine Vol.4(1) 2015: 36-45

Download Full-text

The effect of pre-operative stoma-site marking on peristomal skin health and quality of life

Gastrointestinal Nursing ◽

10.12968/gasn.2021.19.sup4a.s34 ◽

2021 ◽

Vol 19 (Sup4a) ◽

pp. S34-S41

Author(s):

Belén Bueno Cruz ◽

Isabel Jiménez López ◽

Alejandra Mera Soto ◽

María Carmen Vazquez ◽

María José Fabeiro Mouriño ◽

...

Keyword(s):

Quality Of Life ◽

Health Professionals ◽

First Line ◽

Stoma Site ◽

The Mean ◽

Peristomal Skin ◽

Stoma Site Marking ◽

Permanent Ostomy ◽

Stoma Care

Aim: To determine the effect of pre-operative stoma-site marking (siting) on ostomates' peristomal skin health and quality of life (QoL). Methods: The Uses and Attitudes in Ostomy (U&A Ostomy) study was conducted across 148 stoma units in Spain. Specialist stoma care nurses personally assessed each ostomate and collected demographic and clinical data. This included whether the stoma was sited before surgery, the stoma's characteristics, the type of appliance used, any stoma-related complications and frequency of leakage. Participants were also assessed using the Discolouration, Erosion, Tissue overgrowth (DET) Ostomy Skin Tool (0–15), Global Wellbeing scale (0–10) and Stoma-QoL scale (0–100). Findings: The study included 871 ostomates. Of these, 64% were male and 36% were female, the mean age was 64±13 years and the mean BMI was 26.5±11; 57.5% had a colostomy, 28.6% had an ileostomy and 13.9% had a urostomy. A stoma site had been pre-operatively marked and respected in 53.1%, marked but not respected in 2.1% and not marked in 44.8% of the cases. The proportion of new ostomates whose stoma had been sited was seen to have increased in recent years. Stoma siting was associated with a permanent ostomy (p=.0001), absence of effluent leakage (p=.008), absence of complications (p<.0001), lower DET score (p.0007), higher Stoma-QoL score (p=.018) and higher global wellbeing score (p=.0018). Multivariate analysis revealed that pre-operative stoma siting (p<.0001) and type of ostomy (p<.0001) were independent predictors of optimal peristomal skin (DET score 0). The Stoma-QoL score was higher in ostomates with pre-operative stoma siting (58.3±10.2 vs 57±10.3; p=.018). Global wellbeing was also higher in those with pre-operative stoma siting (7.6±1.8 vs 7.19±1.9; p=.0018). Conclusions: In Spain, pre-operative stoma siting is not yet consistently applied in practice, despite the educative efforts made by health professionals. Stoma siting is a first-line opportunity to reduce the occurrence of peristomal skin complications (PSCs), and thus it is associated with fewer PSCs and greater self-perceived QoL. More effort is needed to extend this practice to the majority of patients undergoing stoma-forming surgery.

Download Full-text

Stoma care appliances: an overview

Gastrointestinal Nursing ◽

10.12968/gasn.2021.19.sup9.s14 ◽

2021 ◽

Vol 19 (Sup9) ◽

pp. S14-S19

Author(s):

Gemma Harris

Keyword(s):

Care Nurse ◽

Application Technique ◽

Stoma Complications ◽

Peristomal Skin ◽

Stoma Care

A core aim in stoma care is to ensure the appliance (also known as a pouch or bag) establishes and maintains a secure seal, and so identifying the appropriate appliance for an individual ostomate is vital. This article presents a summary of the latest available range of stoma appliances on the market. There are two types of pouching systems: one and two piece. There are three main types of stoma appliances: closed, drainable and urostomy. Stoma care nurses need to be well informed about stoma appliance innovation, so that they can advise patients on what appliance is best for them. It is also the role of a stoma care nurse to educate patients on the technique for appliance application. If a patient is wearing an inappropriate appliance or they have a poor application technique, this can result in stoma complications, such as leakage and/or sore peristomal skin.

Download Full-text

Intestinal Stomas—Postoperative Stoma Care and Peristomal Skin Complications

Clinics in Colon and Rectal Surgery ◽

10.1055/s-0037-1598159 ◽

2017 ◽

Vol 30 (03) ◽

pp. 184-192 ◽

Cited By ~ 18

Author(s):

Emily Steinhagen ◽

Janice Colwell ◽

Lisa Cannon

Keyword(s):

Contact Dermatitis ◽

Daily Life ◽

Major Change ◽

Irritant Contact Dermatitis ◽

Resource Poor ◽

Peristomal Skin ◽

Skin Conditions ◽

Peristomal Complications ◽

Stoma Care

AbstractIntestinal stomas are necessary for several colon and rectal conditions and represent a major change in the new ostomate's daily life. Though dehydration is the most frequent etiology requiring readmission, irritant contact dermatitis and a host of other peristomal skin conditions are more common complications for ostomates. Wound, ostomy, and continence nurses are invaluable resources to both ostomy patients and providers. A few simple interventions can prevent or resolve most common peristomal complications. Good stoma care is possible in a resource-poor environment.

Download Full-text

Evaluating evidence for stoma care nursing: appraising a randomised controlled trial of ostomy skin barriers

Gastrointestinal Nursing ◽

10.12968/gasn.2019.17.7.38 ◽

2019 ◽

Vol 17 (7) ◽

pp. 38-42

Author(s):

Jackie McPhail

Keyword(s):

Randomised Controlled Trial ◽

Adaptive Design ◽

Controlled Trial ◽

Skin Barrier ◽

Evidence Base ◽

Skin Condition ◽

Peristomal Skin ◽

Critical Appraisal Skills ◽

Randomised Controlled ◽

Stoma Care

Background: Nursing practice should be evidence-based. As such, nurses should be able to rank sources according to a hierarchy of evidence and critically appraise the validity of studies. This is especially important in stoma care, where high-quality evidence is limited. Methods: Evidence appraisal is made easier by tools, such as the Critical Appraisal Skills Programme (CASP) for Randomised Controlled Trials (RCT). CASP was used to critique the ADVOCATE Trial, ( Colwell et al 2018 ), A Randomised Controlled Trial Determining Variance in Ostomy Skin Condition and the Economic Impact (ADVOCATE Trial), which had an adaptive design and compared the cost efficiency and efficacy of a ceramide-infused two-piece skin barrier with a comparator. The participants were randomised, and the trial was double blinded. Results: The trial addressed clearly focused issues. The improvement in cost efficacy for the trial group was statistically significant (p=0.017); in addition, three of six tertiary objectives were also statistically significant. Improvement in peristomal skin health was noticeable but not statistically significant. The results can be applied to other ostomy patient populations, and all clinically important outcomes were considered. Conclusion: CASP provided a staged and structured approach to review an RCT. It can help specialist nurses to find and apply relevant study findings to practice. CASP assessment found the ADVOCATE trial to be a reliable evidence base on which stoma care nurse could adjust their practice to optimise costs and peristomal skin health.

Download Full-text

Effect of a Mobile Patient Education Application on Adjustment to Stoma and Development of Peristomal Skin Lesions: A Quasi-Experimental Study

Wound Management & Prevention ◽

10.25270/wmp.2021.12.3040 ◽

2021 ◽

Vol 67 (12) ◽

pp. 30-40

Author(s):

Eylem Yiğitoğlu ◽

Merdiye Şendir

Keyword(s):

Skin Lesions ◽

Subscale Score ◽

Mobile App ◽

Control Group ◽

Discharge Data ◽

The Third ◽

Quasi Experimental ◽

Peristomal Skin ◽

Satisfaction With Education ◽

Stoma Care

BACKGROUND: Patients with a stoma face difficulties in everyday life. A mobile application (app) may assist them in managing their stoma and adjusting to change. PURPOSE: This study developed a mobile app for patients with a stoma and evaluated its effectiveness in improving psychosocial adjustment, self-care, and prevention of peristomal skin lesions. METHODS: The research utilized a quasi-experimental design and was conducted using a posttest control group. The study consisted of 60 patients who had undergone surgery in 3 university hospitals in Istanbul, Turkey, from November 2018 through December 2019. The experimental group (n = 30) used the STOMA-M mobile app, and the control group (n = 30) used an educational booklet that contained images and text that correlated to the content found in the app. Data collection was carried out using an individual characteristics assessment form, Ostomy Adjustment Inventory (OAI-23), Peristomal Skin Lesions Assessment and Classification Instrument, and a stoma care training evaluation form in the first and third months after discharge. Data were analyzed using IBM SPSS Statistics 22.0 software. RESULTS: Sociodemographic characteristics of individuals in the experimental and control groups were similar; 70% (n = 42) required stoma placement because of cancer treatment. More than half of the participants (53.3%; n = 32) had an ileostomy, and 78.3% (n = 47) had a temporary, open stoma. The experimental group’s OAI-23 score, social engagement subscale score, stoma care status, and satisfaction with education e high. The OAI-23 scores in the control group were not significant, and their anger subscale score and the score of item 16, Caring for my stoma is difficult, decreased in the third month compared with baseline. Peristomal skin lesions did not develop in the control group at the third month of follow-up. CONCLUSION: The levels of adjustment to stoma, ability to care for the stoma themselves, and satisfaction with education received were higher in individuals using the mobile app compared with those using the printed booklet. However, the app was not effective in preventing peristomal skin lesions. Additional studies are needed to determine what features of a mobile app may be useful for preventing such lesions.

Download Full-text