Name of the Procedure:

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

Summary

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.

Purpose

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.

Indications

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.

Preparation

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.

Duration

The application process typically takes about 5-10 minutes.

Setting

Where Performed:

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

Personnel

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.

Benefits

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.

Recovery

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.

Alternatives

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.