Paraileostomy recontouring by collagen sealant injection: a novel approach to one aspect of ileostomy morbidity. Report of a case.
BACKGROUND
Poorly fitting stoma appliances, resulting in stomal leakage and subsequent skin excoriation, remain a significant cause of ileostomy-related morbidity. One cause of ill-fitting stoma bags is the presence of parastomal dermal contour defects/irregularities. These may occur after surgical complications or change in patient weight and body habitus.


METHODS
We report the case of a 29-year-old man who, after panproctocolectomy and formation of ileostomy for ulcerative colitis, experienced significant problems with stoma bag application because of dermal contour defects. As a result, he suffered from significant stomal leakage and skin excoriation. After a single treatment of cutaneous parastomal infiltration of porcine collagen (Permacol Injection), applied stoma bags achieved a watertight seal, and the patient experienced complete and sustained resolution of his symptoms.


CONCLUSIONS
Porcine collagen is a safe, versatile, and relatively easy method of restoring irregular skin defects surrounding abdominal stomas, thus resolving the significant patient morbidity associated with ill-fitting stomal appliances. Such a technique avoids the need for surgical stoma refashioning, which may be associated with significant morbidity and unsatisfactory outcomes.
Smith
G H M
GH
Department of General Surgery, St. John's Hospital at Howden, Livingston, Scotland, United Kingdom.
Skipworth
R J E
RJ
Terrace
J D
JD
Helal
B
B
Stewart
K J
KJ
Anderson
D N
DN
D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use*; D003093:Colitis, Ulcerative / Q000601:surgery; D003094:Collagen / Q000627:therapeutic use*; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects*; D008297:Male; D012871:Skin Diseases / Q000209:etiology* / Q000517:prevention & control*; D054047:Surgical Stomas
D001672:Biocompatible Materials; C422414:Permacol; D003094:Collagen