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Ostomy skin barrier, non-pectin based, paste, per ounce

HCPCS code

Name of the Procedure:

Ostomy Skin Barrier, Non-Pectin Based, Paste, Per Ounce (HCPCS Code: A4405)
Common Names: Ostomy paste, Skin barrier paste


This procedure involves the application of a non-pectin based paste designed to protect and maintain the skin area around an ostomy. The paste helps to create a secure seal and prevents leakage from the ostomy bag.


Medical Conditions or Problems Addressed:

  • Protects peri-stomal skin from irritation and damage caused by ostomy output.
  • Enhances the adhesion of ostomy appliances.

Goals or Expected Outcomes:

  • Reduce skin irritation and damage.
  • Provide a secure seal to prevent leakage, thereby improving patient comfort and confidence.


Specific Symptoms or Conditions:

  • Patients who have undergone ostomy surgery (e.g., colostomy, ileostomy, urostomy).
  • Individuals experiencing skin irritation or breakdown around the stoma.
  • Patients requiring enhanced adhesion of their ostomy appliances.

Patient Criteria:

  • Must have an established ostomy.
  • Experiencing issues with appliance adhesion or skin irritation.


Pre-procedure Instructions:

  • Clean the peristomal skin thoroughly with mild soap and water.
  • Ensure the skin is completely dry before application.

Diagnostic Tests or Assessments:

  • Visual inspection of the peristomal skin for signs of irritation or breakdown.
  • Assessment of the current ostomy appliance fit.

Procedure Description

  1. Clean and Dry: Begin by cleaning the skin around the stoma and ensuring it is dry.
  2. Apply Paste: Carefully apply a small amount of the non-pectin based paste to the peri-stomal skin.
  3. Form a Barrier: Spread the paste evenly to form a uniform barrier.
  4. Secure Appliance: Attach the ostomy appliance over the paste, pressing gently to create a secure seal.

Tools and Equipment:

  • Non-pectin based ostomy skin barrier paste
  • Ostomy appliance (bag)

Anesthesia or Sedation:

  • Not applicable, as this is a non-invasive procedure.


The application process typically takes about 5-10 minutes.


Where Performed:

  • Can be done in various settings including a hospital, outpatient clinic, or at home by the patient or a caregiver.


Healthcare Professionals Involved:

  • Ostomy care nurse or wound care specialist.
  • Can also be performed by the patient or a trained caregiver.

Risks and Complications

Common Risks:

  • Minor skin irritation or allergic reaction to the paste.

Rare Risks:

  • Severe allergic reactions.

Possible Complications:

  • If improperly applied, paste can reduce the effectiveness of the barrier and lead to leakage.
  • Management involves reassessment by a healthcare professional for proper technique or alternative products.


Expected Benefits:

  • Protection of the skin around the stoma, reducing irritation and breakdown.
  • Increased confidence and comfort due to the secure seal of the ostomy appliance.

Realization of Benefits:

  • Benefits are typically noticed immediately after correct application and continue with ongoing use.


Post-Procedure Care:

  • Regular monitoring and inspection of the peristomal skin.
  • Maintain good hygiene and consistent ostomy appliance changes.

Expected Recovery Time:

  • None required, as it is a maintenance procedure.

Restrictions or Follow-up:

  • Regular follow-up with an ostomy nurse or healthcare provider to address any ongoing skin issues.


Other Treatment Options:

  • Pectin-based ostomy pastes.
  • Ostomy hydrocolloid barriers.
  • Skin barrier rings or strips.

Pros and Cons of Alternatives:

  • Pectin-based pastes may be more suitable for some patients but can cause allergic reactions in others.
  • Hydrocolloid barriers and rings may offer different forms of protection and adhesion but can vary in the ease of use and comfort.

Patient Experience

During the Procedure:

  • Patients might feel a mild sensation as the paste is applied but generally no discomfort.

After the Procedure:

  • Expected to feel increased comfort and less skin irritation.
  • Pain management is typically not necessary as the procedure is non-invasive and painless.

Comfort Measures:

  • Ensuring the skin is dry before application to prevent maceration.
  • Using additional skin protective films if necessary.

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