Prevention strategies for peristomal skin

April 16th, 2009 Filed Under:

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Prevention Strategies for Peristomal Skin
By becoming informed about the signs to look for in peristomal skin problems, you have taken the first step towards preventing them. Peristomal skin is the skin around the ostomy stoma. People with Ostomys are more prone to skin problems such as rashes, infections caused by moisture accumulation, reaction to different glues, and build up of normal fungi. Prevention is the key, early detection can catch serious complications, and unnecessary discomfort.



Normal skin around an Ostomy stoma
	Normal skin should be intact and clear. To keep skin intact, ensure that the skin is dried well before applying a new pouching system. Examine skin and stoma before applying new pouch. If there is any itching, burning or leakage change pouch immediately. Ensure that stoma size is re-measured periodically.



Dermatitis Inflammation to the skin, two common types are irritant or allergic reaction.
	Allergic Dermatits is a allergic reaction to skin barrier, tape collar, adhesive remover or skin prep and paste. Presents with itching, burning, stinging and red rash Treatment Discontinue use of adhesive remover or skin prep Change paste to type with lower alcohol content such as Coloplast Strip paste Calamine Lotion painted over red area will act as a barrier and prevent further irritation Sween cream can be used to moisturize dry red area Cortate (steroid lotion) can help decrease redness (If rash or redness persists longer than 2 weeks contact ET or Doctor)
	Irritant dermatitis occurs if the pouching system has leaked. Presents as weepy sores with possible bleeding. Causes discomfort. This can occur if there has been leakage or skin stripping by frequent pouch removal or removing the barrier in a rough manner. Prevention Remove skin barrier slowly Dry skin well after cleansing area Examine skin Use water only to cleanse area if skin is irritated If there has been stripping of skin Duoderm may be used to protect the open area.Stomahesive Powder may also assist to dry weepy areas If skin irritation persists longer than 2 pouch hanges contact ET or Doctor



Folliculitis
	Folliculitis is an inflammation of the hair follicles which is caused by removal of hair by when skin barrier is removed aggressively. Prevention Clip or shave hair (Mustache trimmer is effective) Dust affected area with Nystatin (antifungal powder) This is an antibiotic therefore should be used sparingly. (Contact Doctor or ET if condition persists after 2 applications. Nystatin may be purchased without a prescription)



Candida Albicans (Fungal Infection)
	Candida is normally found in the GI Tract, it is a yeast-like fungus that can cause an infection around the stoma. People with stomae are prone to Candida because area around stoma is warm and moist and covered. This infection may spread to the groins as this area may be moist. Presents as redness and itching. Treatment Nystatin powder may be sprinkled on affected area as well as 3M No Sting spray Use a cotton cover over pouch to keep area dry Use hair dryer on low setting to dry area as well as cloth cover of pouch



If any of the above conditions persist longer than 2 pouch changes contact ET or Doctor

Prevention strategies for peristomal skin