WOC, Connecticut Clinical Nursing Associates, LLC, Bristol Hospital Wound, Ostomy, Lymphedema Center, Bristol, Connecticut 06011, USA.
J Wound Ostomy Continence Nurs. 2011 Nov-Dec;38(6):676-9. doi: 10.1097/WON.0b013e318234550a.
Peristomal skin alterations under ostomy barrier wafers are a commonly reported problem. While a number of interventions to manage this issue have been reported, the use of a topically applied cyanoacrylate has received little attention. This case series describes the use of a topical cyanoacrylate for the management of peristomal skin alterations in persons living with an ostomy.
Using a convenience sample, the topical cyanoacrylate dressing was applied to 11 patients with peristomal skin disruption under ostomy wafers in acute care and outpatient settings. The causes of barrier function interruption were also addressed to enhance outcomes. Patients were assessed for wound discomfort using a Likert Scale, time to healing, and number of appliance changes. Patient satisfaction was also examined.
Average reported discomfort levels were 9.5 out of 10 at the initial peristomal irritation assessment visit decreased to 3.5 at the first wafer change and were absent by the second wafer change. Wafers had increasing wear time between changes in both settings with acute care patients responding faster. Epidermal resurfacing occurred within 10.2 days in outpatients and within 7 days in acute care patients. Because of the skin sealant action of this dressing, immediate adherence of the wafer was reported at all pouch changes.
造口底盘下的造口周围皮肤改变是一个常见的问题。虽然已经报道了许多管理这个问题的干预措施,但局部应用氰基丙烯酸酯的应用却很少受到关注。本病例系列描述了局部应用氰基丙烯酸酯治疗造口周围皮肤改变的情况。
使用便利样本,在急性护理和门诊环境下,将局部氰基丙烯酸酯敷料应用于 11 名因造口底盘下的造口周围皮肤破裂而导致屏障功能中断的患者。还针对造成障碍的原因进行了处理,以增强治疗效果。使用李克特量表评估患者的伤口不适,评估愈合时间和更换造口袋的次数,并检查患者的满意度。
最初在造口周围刺激评估就诊时,患者报告的平均不适程度为 10 分中的 9.5 分,在第一次更换底盘时降至 3.5 分,第二次更换底盘时已完全消失。在两种环境下,底盘更换之间的磨损时间均逐渐增加,急性护理患者的反应速度更快。表皮重塑在门诊患者中 10.2 天内完成,在急性护理患者中 7 天内完成。由于这种敷料具有皮肤密封剂的作用,在所有造口袋更换时都立即报告了底盘的附着情况。