title: The effects of using a moldable skin barrier on peristomal skin condition in persons with an ostomy: results of a prospective, observational, multinational study.
abstract: Peristomal skin problems are the most commonly experienced physical complication following ostomy surgery and often are caused by leakage or a poorly fitting skin barrier. A prospective, multicenter, observational evaluation of persons with a colostomy, ileostomy, or urostomy was conducted to assess the incidence of peristomal lesions and level of patient satisfaction with moldable skin barriers. Peristomal skin was assessed using the Studio Alterazoni Cutanee Stomale (SACS™) scale, and patients were asked to rate barrier application and usage variables. During a period of 12 months, and using convenience sampling, 561 patients from 90 centers in 3 countries were enrolled: 28 in Germany, 48 in Poland, and 14 in the United States. Participants included 277 new stoma patients (average time since surgery 0.3 months; average age 64.7 ± 12.86 years) who had a colostomy (174), ileostomy (72), or urostomy (10); and 284 patients with an existing stoma (average time since surgery 18.2 months; average age 66 ± 12.62 years) who had a colostomy (174), ileostomy (88), or urostomy (22) who experienced skin complications using a traditional skin barrier (ie, a solid or flexible barrier with precut opening or one requiring cutting an opening to accommodate the stoma). All patients were assessed at baseline and after 1 and 2 months. In the patients with a new stoma, 225 (90.4%) had intact skin at baseline, 239 (95.6%) had intact skin after 2 months, and 98% rated overall satisfaction with the barrier as good or excellent. In the patients with an existing stoma, intact skin was observed in 103 patients (39.5%) at baseline and 225 (86.2%) after 2 months, with 96.5% of patients rating overall satisfaction with the barrier as good or excellent. In this group, the proportion of patients who used accessory products (eg, belt, deodorants, powder) was 73% at baseline and 64.2% at the 2-month follow-up. The moldable skin barriers evaluated were effective in preventing and healing peristomal skin complications and were rated as good or excellent by the vast majority of patients. Comparative studies are warranted to evaluate the efficacy and cost-effectiveness of this moldable skin barrier.
authors.affiliation: Nicolaus Copernicus University; and Ludwik Rydygier Collegium Medicum, Department of Surgery, Clinic of Vascular Surgery and Specialistic Center for the Treatment of Chronic Wounds, University Teaching Hospital of Dr. Jurasz, Bydgoszcz, Poland.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Szewczyk
authors.affiliation: Ostomy Outpatient Clinic, Medical University Teaching Hospital, Bialystok, Poland.
authors.forename: Grazyna
authors.initials: G
authors.lastname: Majewska
authors.affiliation: Colorectal Surgery, Rhode Island Colorectal Clinic, Pawtucket, RI; email: marycetn@aol.com.
authors.forename: Mary V
authors.initials: MV
authors.lastname: Cabral
authors.affiliation: Rehatechnik Jesse, Velbert, Germany.
authors.forename: Karin
authors.initials: K
authors.lastname: Hölzel-Piontek
mesh_terms: D000328:Adult; D000368:Aged; D003125:Colostomy / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D010030:Ostomy / Q000534:rehabilitation*; D011446:Prospective Studies; D017592:Skin Care / Q000379:methods*