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Peristomal skin care

Help to avoid skin problems around your stoma

Unlike wounds, where the aim of the treatment is usually the closure of the wound, stomas are surgical openings on the surface of your abdomen intended to remain open to drain the stoma effluent. If peristomal skin disorders occur, special care is required.^[1,2] This is why peristomal skin needs to be carefully looked after to maintain its health and avoid dermatological complications. Healthy skin around the stoma is essential for good adhesion and the overall well-being.

To reduce the risk of peristomal skin complications, preventive measures such as having good skin hygiene and using stoma appliances that suit your stoma and skin, are the most important elements of care.

After surgery

Peristomal skin and wound care

Don’t put pressure on yourself. Give yourself time before resuming your activities after surgery. The mucocutaneous junction (where mucosa transitions to skin), the abdominal wall, and the muscle wall need to adapt and recover from surgery. Your stoma nurse will show you how to protect your stoma, wounds and peristomal tissue.

Skin complications

Possible causes of problems

too strong adhesive or not sticky enough adhesive
skin excoriation and irritation from the stoma output
chemical irritants or allergic substances from the adhesive
complications from surgery, e.g. prolapse or perforation of the mucocutaneus junction, etc.
infections, e.g. yeast
complications caused by an underlying disease, e.g. pyoderma gangrenosum of the skin or fistula due to Crohn's disease

Tips to help avoid peristomal skin irritations

Because everyone is different, it is best to consult your stoma care nurse for advice on your specific needs. The following are therefore only general recommendations:

Keep your skin dry. This is essential to obtain a good adhesive seal. After showering, bathing or swimming with a bag on, dry the skin and the bag system carefully. For more tips, click here.
You could protect the skin by using a protective moisture barrier.
You may prefer a two-piece bag system. With such a system the adhesive baseplate can remain on the skin for several days, while the bag is changed as needed. This may be gentler on sensitive skin and help prevent skin stripping.
Use stoma bags with skin-friendly adhesive skin protectors that form a secure seal around the stoma.
Remove adhesive skin protectors gently to avoid stripping the skin. You could consider using adhesive removers.
If you suffer from stoma leakage, think about protective skin barriers such as pastes or fillers or a barrier seal such as stoma rings.
Furthermore, check with your stoma care nurse to make sure your appliance is appropriate for the size and shape of your stoma. If you are using a flat stoma system, a convex stoma bag may be an option to help prevent leakage. Find more information here.
If using a convex appliance, a stoma belt, such as B. Braun's Ally belt, can help to provide security of the seal around the stoma. Some convex appliances, such as B. Braun's convex range, have several belt loops enabling the use of 2 belts to help to spread the pressure evenly around the stoma and help prevent leakage or pressure through the stoma.