The deep crease indentation either side of the stoma.
Case Study Location
UK
Patient
66 year old male.
Type of Stoma
Urinary diversion for bladder cancer, in 2000.
Before Dermacol
This gentleman made contact with the local stoma department, having struggled for quite a while dealing with leaking pouches and severe sore skin. His clothes were soiled and evidence of urine odour was present. There were initial leakage problems after his operation and a convex pouch was deemed appropriate, a washer, some paste and a belt. His stoma was slightly spouted and sat in a moat, and the adhesive was deteriorating quickly. The hospital stoma nurse requested reassessment to improve the management of leakages. The skin had some signs of healing from the care given but the patient was still only getting less than a day wear time. The stoma was spouted and sat in a deep recess. The appliance aperture was not cut large enough. A poor stoma care technique was recognised as being partly responsible for his leakage.
Products
The hospital stoma nurse had used hydrocolloid powder to dry up the macerated areas – signs of healing are evident from picture 1. Secuplast hydro flange extender was also applied to aid adhesion and give a secure fitting.
Results
The complex pouch change needed revising. In place of the washer and paste, it was decided to try the Dermacol collar, adding only a small application of stoma paste, as pictures 2 and 3. Since this new routine has started, no leaks have been reported. Wear time has increased to 48 hours. Skin is now showing a marked improvement after less than 10 days. Dermacol collar after 48 hours’ wear time, picture 4.