The Dermatology Centre, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
Dermatol Ther (Heidelb). 2014 Dec;4(2):271-9. doi: 10.1007/s13555-014-0058-x. Epub 2014 Jul 9.
Stomal leaks can be associated with significant social, psychological and physical morbidity for ostomy patients. Poor fitting of the stoma appliance due to irregularities of skin contours is one cause of stoma leaks which commonly result in secondary irritant dermatitis prompting presentation to a dermatologist. In addition to skin-directed topical therapy and review of stoma appliances, correction of contour defects with intradermal injections of filler materials is one possible treatment to improve adhesion and reduce leaks.
We report eight cases of ostomy patients, who presented with stoma leaks and associated dermatitis, who were treated with intradermal injections of the porcine collagen (Permacol™) or subcutaneous injections of polyacrylamide hydrogel (Aquamid Reconstruction™) for correction of skin contour defects. Resolution or improvement of symptoms was achieved for five patients, and no complications were noted as a result of treatment.
This report represents the largest series of ostomy patients treated for correction of peristomal skin contour defects with injection therapy. Treatment was well tolerated and performed in the outpatient setting under local anesthetic. Attempted correction of peristomal skin contour defects using injection of filler materials represents a potential alternative to surgical intervention and can result in significant benefits for the patient.
造口漏出可能会给造口患者带来严重的社交、心理和身体上的困扰。由于皮肤轮廓不规则，造口器具适配不当是造口漏出的一个原因，通常会导致继发性刺激性皮炎，促使患者去看皮肤科医生。除了针对皮肤的局部治疗和造口器具的检查外，用真皮内注射填充剂来纠正轮廓缺陷也是改善贴合度和减少漏出的一种可能的治疗方法。
我们报告了 8 例造口患者，他们因造口漏出和相关皮炎就诊，我们用猪胶原蛋白（Permacol™）进行真皮内注射或用聚丙烯酰胺水凝胶（Aquamid Reconstruction™）进行皮下注射，以纠正皮肤轮廓缺陷。5 例患者的症状得到缓解或改善，治疗过程中未出现任何并发症。
本报告代表了用注射疗法治疗造口患者纠正围造口皮肤轮廓缺陷的最大系列病例。治疗在局麻下于门诊环境中进行，患者耐受性良好。用注射填充剂来纠正围造口皮肤轮廓缺陷是一种替代手术干预的潜在方法，可以为患者带来显著的益处。
