Peristomal skin damage: assessment, prevention and treatment.

The majority of ostomates experience peristomal complications, the most common of which is skin damage. Healthy peristomal skin is essential for pouch adherence, which prevents effluent from seeping onto the skin. The aim of good stoma management is to prevent peristomal skin soreness and, if this arises, to minimise its effects. Practitioners need to have a good understanding of the causes of skin breakdown and how to treat and prevent it. Appliances and accessories need to be assessed to ensure they are appropriate for each individual stoma to prevent leakage of effluent and maintain healthy peristomal skin. Several strategies and products can be used to protect and treat the skin, including barrier creams and films, powders, pastes, seals, cleansers, lotions and stoma accessories. Misuse of products can affect patient care and clinical outcomes, and increase costs. Good-quality stoma care patient education improves outcomes, is part of good-quality care and boosts efficiency in nursing services. This article focuses on good skin care regimens, preventing skin damage, particularly peristomal damage, assessing and treating specific peristomal skin conditions, and patient education.

Care of the stoma: complications and treatments.

Quality patient education of how to care for their stoma improves patient outcomes and enhances quality of care and efficacy. There is a need for home visits to assist ostomates with rehabilitation of their stoma formation, as they often feel stigmatised and are likely to withdraw from social activities. It has previously been highlighted that community care is often the weakest link in rehabilitation, highlighting the need for effective teamwork and collaboration between stoma nurse specialists and community nurses. This article will focus on some of the more common complications of stomas which will be seen in the community setting, how to treat these conditions and when patients should be referred to the specialist stoma care nurse.