Most patient visits to stoma care nurses happen due to peristomal skin complications but there is a tendency in patients to not seek care earlier – potentially due to embarrassment or failure to recognise an emerging skin problem early – this increases the burden on both nurses and healthcare systems as the patient presents when the peristomal skin has already deteriorated significantly (Rolls et al, 2023). It can take several weeks and substantial nursing time to manage a single case of PMARSI (Kelly-O’ Flynn et al, 2020). Therefore, effectively managing peristomal skin complications and reducing stoma-related healthcare costs can have significant benefits for clinicians and the NHS. A two-pronged approach to managing peristomal skin complications To prevent PMASD progression, it is important to create a barrier between any potential irritants/effluents from stomas reaching the peristomal skin; similarly, for PMARSI, it is essential to remove the stoma pouches with care as they are attached via strong adhesives to potentially fragile skin. For mild PMASD, a two-pronged approach [Figure 3] is recommended, where a barrier film is used, as prescribed by a
healthcare professional (HCP), to protect the peristomal skin from irritants and a medical adhesive remover is used to gently remove the stoma device. Copson and Freitas (2021) reported that, in a study of 101 patients who used a barrier film (Medi Derma-S Total Barrier Film, Medicareplus International), 63% of all respondents reported an improvement in their skin while 33% experienced no change. Kelly-O’Flynn et al (2020) showed that using a medical adhesive remover (Lifteez Medical Adhesive Remover, Medicareplus International) not only helps in reducing pain during dressing or pouch removal, but it also reduces the risk of skin damage and MARSI. It is important that people with stoma are recommended a barrier film as prescribed by a HCP and educated about its appropriate use for mild/moderate/severe skin complications. Therefore, using a barrier film and a medical adhesive remover can form a routine stoma care regimen that may not only help manage mild/moderate peristomal skin complications, but also provide significant long-term cost benefits to the NHS.
Saving stoma care costs for the NHS In addition to overall cost-saving benefits, the Medicareplus stoma skincare product range also provides a cost-effective
1. Remove
3. Protect
• Apply Medi Derma-S Total Barrier Film to protect the skin underneath the replacement appliance.
• Gently lift the edge of the appliance • Spray or wipe using Lifteez Medical
Adhesive Remover underneath the edge whilst gradually and gently removing the appliance.
2. Clean
4. Replace
• Once the Medi Derma-S Total Barrier Film is fully dry, apply the replacement pouch as normal. When using the Medi Derma-S Total Barrier Film applicator or wipe, allow 5-10 seconds to fully dry, holding open any skin folds to ensure complete drying. If using the Medi Derma-S Total Barrier Film pump spray or aerosol, allow up to 30 seconds to fully dry, again holding open any skin folds for complete drying.
• Once the appliance has been removed, it is important to remove any adhesive residue • Usa a Lifteez Wipe or spray Lifteez Aerosol on a gauze swab and gently wipe any residue off the skin • Gently clean and dry around the peristomal site in accordance with clinical guidance • Lifteez dries in seconds and does not compromise the adhesion of the replacement pouch.
Figure 3. A two-pronged approach for managing peristomal skin complications. Barrier film re-application is recommended every 24 to 72 hours, depending on the frequency of cleansing and severity of skin damage. When used under adhesive dressings or devices, reapply at each dressing or device change.
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