I am working with a pediatric patient that has midline prolapsed fistulae complicated by old surgical creases and divets from former surgeries. In addition, due to poor pouch fit, the pt has extensive maceration on the lower R/L abdomen. The pt is, as a result, in pain, both physiologically and psychologically. The pt refuses stomapast and stomadhesive as they burn the macerated skin. The current ostomy/continence staff has attempted multiple times with limited success to pouch the site in a way that contains the output.
My current question is (and there will possibly be more), is there an alternative to stomadhesive that might be used? I've heard of a "homemade" version using stomapowder and glycerine - but as I'm wearing in on my hand right now, I'm noticing cracks in it and it does take a while to firm up/dry.
Apr 12, '13
What about trying the Cavilon 3M Durable barrier cream on the maceration before applying the pouch? It literally leaves a polymer on the skin, doesn't burn, is latex free and you can place adhesives directly on top of the cream. This stuff is awesome! I have used it very successfully under all sorts of dressings without issue including a gastrocutaneous fistula with copious drainage.
Apr 13, '13
Above poster hit it, 3M cavilon products are amazing, I love the no sting spray, as well as the durable barrier. Coloplast also has some silicone barrier sprays for super sensitive skin and macerated/denuded peristomal skin.
Apr 15, '13
Thank you! I will try that - and will let you know my experience with it.
Apr 19, '13
Update: We had a 3M brand of durable barrier cream. I tested it on my hand/arm before introducing it to the pt. Love, LOVE the stuff! However, the pt refused to try it.