Peristomal skin/wound care

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Peristomal skin & wound care

During the first months after your operation, it is important that you take care of your abdominal wound (if you have one). It is an important part of your recovery as the muscles around the wound have been weakened. The E.T. nurse may visit you if the wound takes longer to heal.

If your rectum has been removed you will have a wound in your bottom that will be checked by an E.T. nurse and your consultant will check this at your first clinic appointment.

Don’t strain yourself! Give yourself time before resuming activities such as vacuuming, lifting heavy objects, moving furniture or ironing, for example. Also, your physiotherapist will show you how to protect the muscles around the wound when you cough.

Managing peristomal skin complications

Unlike wounds, where the ultimate treatment goal is healing, stomas are a breach of the skin that are designed to stay open in order to drain the stoma effluents. Complications of the peristomal skin disorders are common and require specific management⁽¹⁾. Therefore, peristomal skin requires scrupulous care to maintain its health and avoid dermatological complications. Healthy skin around the stoma is essential to ensure good adhesion, without which the risk of leaking and further skin damage is increased and creates a vicious circle of skin damage and pouch leakage ⁽²⁾ .

In order to prevent peristomal skin complications, preventive actions such as having a good skin hygiene are the most important element of care.

Yeast infection

A yeast infection or candidiasis is an infection which is caused by a fungus called candida albicans. It may be due to excessive sweating on broken or fragile skin and/ or under antibiotic therapy. It presents initially as a pustule and can then develop into erythemic confluent plaques and be accompanied by burning and/ or itching sensations. Treatment of yeast infection is based on an antifungal powder and adequate preventive measure such as avoiding local moisture and/ or preventing maceration with skin sealants such as the Askina^® Barrier Film and/ or Superfiller.

If you believe that you have developed a yeat infection, please consult your healthcare professional.

Skin care tips

Clean the skin with a pH-balanced product (or in some cases water alone may be used) ⁽¹⁾. Do not use emollient or oil-based products, nor those that may dry the skin. Avoid chemicals that may cause irritation ⁽²⁾.
Maintain dry skin in order to reduce the risk of yeast infection. Dry skin is also essential to obtain a good adhesive seal. After bathing with the pouch on, dry the skin and the pouching system carefully ⁽¹⁾.
Protect the skin by using non-traumatic skin protectors and cleansing the skin carefully. Remove skin protectors gently in order to avoid trauma/skin stripping. Consider using a skin sealant to prevent trauma in patients with sensitive skin ⁽¹⁾.

^References:

^{1. Herlufsen P et al (2006) Study of peristomal skin disorders in patients with permanent stomas. British Journal of Nursing 15(16):854-62}

^{2. Rolstad BS, Erwin-Toth P (2004) Peristomal skin complications: prevention and management. Ostomy Wound Management 50(9):68-77}

^{3. Gray M, Colwell JC, Doughty D et al (2013) Peristomal moisture-associated skin damage in adults with fecal ostomies. J Wound Ostomy Continence Nurs 40(4):389-99}