title: Paraileostomy recontouring by collagen sealant injection: a novel approach to one aspect of ileostomy morbidity. Report of a case.
abstract: 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.
authors: Department of General Surgery, St. John's Hospital at Howden, Livingston, Scotland, United Kingdom.
authors: G H M
authors: GH
authors: Smith
authors: R J E
authors: RJ
authors: Skipworth
authors: J D
authors: JD
authors: Terrace
authors: B
authors: B
authors: Helal
authors: K J
authors: KJ
authors: Stewart
authors: D N
authors: DN
authors: Anderson
mesh_terms: 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
chemical_list: D001672:Biocompatible Materials; C422414:Permacol; D003094:Collagen