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Treatment of excoriated peristomal skin

Author: Lauraine Martel, Client Care Counselor,wound and ostomy. CSSS Pierre-De Saurel
 
This case study examines the use of Eakin Cohesive® Seals, combined with other products, to treat severely excoriated skin.
 
Patient Details:
  • 79 year old male
  • Stoma surgery in July 2000 to create a colostomy, due to formation of tumorous tissue.
Assessment details: 29th June 2010
  • Patient was assessed on his first admission to hospital and was previously using a Hollister 2 piece appliance
  • Stoma was round, flush and slightly retracted (peristalsis) with an opening at around 6 o’clock. The abdomen was round and deformed with multiple hernias and a crevice from 3-7 o’clock
  • Peristomal skin was excoriated and a wound had developed around the stoma causing serous redness and pain
  • To treat the patient, an Eakin Cohesive® Seal was applied from 3-12 o’clock. AQUACEL® Ag Hydrofiber® Dressing was applied on the wound from 3-9 o’clock with hydrocolloid (DuoDERM® Extra Thin) and the Stanley Procedure (powder and Cavilon™) also used. Reduced pressure was used to apply the ConvaTec Moldable Technology™ convex wafer 404593
  • This resulted in a weartime of 48 hours.
Step 3Step 3Eakin Cohesive® appliedEakin Cohesive® appliedBefore treatmentBefore treatment
 
 
 
 
 
 
Pouch fittedPouch fittedStep 5Step 5Step 4Step 4
 
 
 
 
 
 
 
 
 
 
Assessment details: 9th July 2010
  • When the patient was assessed 10 days later, there was a significant improvement in the skin condition
  • The broken skin had disappeared after using powder, Cavilon™ and Cohesive®
  • There was a great improvement in skin lesions
  • Ulcerations near the stoma have remained the same, so use of AQUACEL® Ag Hydrofiber®
    Dressing and Eakin Cohesive® was continued
  • Pouch weartime is still 2 days
  • As the patient has shown considerable improvement since his last assessment, the same treatment was continued.
9th July 2010: c9th July 2010: c9th July 2010: b9th July 2010: b9th July 2010: a9th July 2010: a
 
 
 
 
 
 
9th July 2010: e9th July 2010: e9th July 2010: d9th July 2010: d
 
 
 
 
 
 
 
 
 
 
 
 
Assessment details: 21st July 2010
  • Skin condition has improved
  • Treatment was continued
  • Frequency of pouch change has increased to 3 days.

21st July 2010: c21st July 2010: c21st July 2010: b21st July 2010: b21st July 2010: a21st July 2010: a

 

 

 

 

 

 

21st July 2010: d21st July 2010: d