2005 Symposium on Advanced Wound Care | |
| 28 |
Case Study
|
Therapeutic skin barrier and flexible ostomy pouch heal denuded peri-fistular skin Antje Bogart, RN, MSN, WOCN, Cleveland Clinic Homecare, Cleveland, OH Clinical Problem. Managing high output fistulas can be challenging for the clinician and patient. The patient’s comfort needs to be considered when choosing a pouching system that contains effluent while promoting healing of denuded, painful peri-fistular skin. This is complicated by irregular abdominal contours. Description of Past Clinical history and management. A 66-year old woman with a history of small bowel obstructions, past surgeries and fistulas was admitted to Home Care for wound and TPN management. Her denuded peri-fistular skin was painful due to leakage of previously used ostomy systems. Current Clinical Approach. The WOC Nurse chose a pouch with a large cutting surface and a spigot that could be connected to a urinary continuous drainage bag. The deep skin folds around the fistula were filled with strip paste and then “evened out” with a skin barrier that expanded the adhesiveness and surface area of the pouch. Patient Outcome. The therapeutic effect of the skin barrier covering the patient’s denuded skin facilitated healing and epithelialization of the peri-fistular skin. Coloplast Skin Barrier, Coloplast Corp., Marietta, GA. Coloplast Strip Paste, Coloplast Corp., Marietta, GA. Coloplast Post-Operative Pouch, Coloplast Corp., Marietta, GA. |
|