Treatment of a premature baby with an ileostomy and mucous fistula
Case study submitted by: Chantal Leduc, ET Nurse, CHU Sainte-Justine
- 2 month old male patient, born premature with many health problems
- Temporary Ileostomy & mucous fistula as a result of Necrotizing Enterocolitis (NEC).
Assessment: 3rd December 2010
- Stoma measures 22mm x 13mm
- Oval, red in colour and slightly protruding
- Ileostomy is situated in the surgical line with a mucous fistula and a Penrose drain
- Currently using Hollister Pouchkins 3778 and Adapt Paste for the Ileostomy, Pouch 3778 used for
the Penrose drain
- Current weartime is 3 days.
Assessment: 7th January 2011
- Since the last assessment, the leaking abdominal wound has dehisced and has caused the
flange to come away, resulting in irritatation to the peristomal skin without any skin loss
- The weartime is now around 2 days
- Have decided to use Aquacel on the midline incision along with transparent film. Eakin
Cohesive Slims® are then used around the ileostomy and the Penrose drain as well as 2 x 3778
- The nursing staff have stressed that they would like a minimum weartime of 48 hours as it takes
1hour 15minutes to complete the pouching process.
Assessment: 10th January 2011
- There is now less irritation around the ileostomy. However, output from the drain has increased
so the skin is irritated around this area
- The AQUACEL® dressing is saturated under the plastic film
- Pouching system is holding well and weartime is 3 days
- Will now use Dimethicone, Eakin Cohesive® Slims will be placed around the ileostomy and
drain as well as on the healed abdominal wound to create a level surface. Transparent film will
be used to hold the drainage bags.
Management: 10th January 2011
Assesment: 31st January 2011
- Product combination is performing well and no
changes are needed to the current care plan.