Name of the Procedure:

Ostomy Skin Barrier Application

• Common names: Ostomy Skin Barrier, Ostomy Dressing
• Technical term: Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity

Summary

An ostomy skin barrier is a medical product used to protect the skin around an ostomy stoma from irritation and to support an ostomy pouch. The skin barrier is designed to provide a secure and durable seal between the skin and the pouch, which collects waste from the stoma.

Purpose

The primary purpose of an ostomy skin barrier is to maintain healthy skin around the stoma, prevent leaks, and ensure that the ostomy pouch adheres properly. This helps manage waste effectively and minimizes the risk of skin irritation or infection.

Indications

• Presence of an ostomy stoma due to conditions such as colorectal cancer, inflammatory bowel disease, or diverticulitis.
• Recurrent skin irritation or stoma leakage.
• Need for extended wear time and secure pouch adhesion.
• Patients with a stoma requiring built-in convexity for better fit and adhesion.

Preparation

• Ensure the skin around the stoma is clean and dry.
• Avoid using lotions or oils near the stoma as they can affect the adhesion of the skin barrier.
• Measure the stoma using a stoma measuring guide and select the appropriate barrier size.
• Have an ostomy care kit ready, including scissors to trim the barrier if necessary.

Procedure Description

1. Cleanse the peristomal skin with water and mild soap, then pat dry.
2. Measure and cut the skin barrier to fit the stoma size.
3. Remove the protective backing from the barrier.
4. Carefully place the barrier around the stoma, ensuring a snug fit without gaps.
5. Secure the ostomy pouch to the skin barrier.
6. Press around the edges to ensure an airtight seal.

Tools and Equipment

• Stoma measuring guide
• Scissors
• Ostomy skin barrier with built-in convexity
• Ostomy pouch

Anesthesia or Sedation

• Not applicable. The procedure is typically performed without anesthesia.

Duration

Application of the ostomy skin barrier usually takes about 10-20 minutes.

Setting

This procedure can be performed at home, in a hospital, or at an outpatient clinic.

Personnel

• Ostomy care nurse or specialist
• General healthcare provider
• The patient (for self-care)

Risks and Complications

• Skin irritation or allergic reaction to the barrier material
• Leakage if not applied correctly
• Potential skin ulcers around the stoma site
• Management includes identifying the cause of any issues and making necessary adjustments.

Benefits

• Protects skin from irritation and infection.
• Ensures secure pouch adhesion, minimizing leakage.
• Gradual adaptation to the ostomy device, enhancing daily comfort.

Recovery

• No recovery time is needed; normal activities can typically be resumed immediately.
• Monitor the skin around the stoma regularly for signs of irritation.
• Follow up with a healthcare provider for routine check-ups and symptom management.

Alternatives

• Standard flat skin barrier without built-in convexity.
• Liquid skin barrier film, which can be sprayed or wiped around the stoma.
• Adhesive ostomy strips or rings.

Pros and Cons

• Alternatives may be easier to apply but might not provide the same level of protection and secure adhesion as the solid convex skin barrier.

Patient Experience

• The patient may feel a slight pressure when applying the convex skin barrier.
• Minimal discomfort expected.
• Pain management typically involves using products to soothe irritated skin.
• Increased confidence in the security and effectiveness of the ostomy pouch system.