Evaluation of a Cyanoacrylate Liquid Skin Protectant in Ostomy Patients with Peristomal Skin Irritation

Introduction: Peristomal skin complications are experienced by more than 80% of patients with an ostomy within 2 years of ostomy surgery.1  Peristomal skin irritation (PSI) is caused by exposure to the stomal effluent, skin cleansers, adhesives, and striping of the epidermis during appliance changes resulting in painful denudation of the peristomal skin.1,2

Objective: Evaluate a cyanoacrylate liquid skin protectant (CLKP) for the treatment of PSI in patients who have either an ileostomy or urostomy pouching system. Method: Five patients were evaluated in this study.

Case 1; a 63 year old with prostate cancer, recent ileal conduit, and profound PSI due to underlying leakage. Case 2; a 73 year old Alzheimer patient with painful PSI requiring narcotic analgesia. Case 3; an 85 year old with ileal conduit resulting from bladder cancer, stomal leakage, frequent appliance changes, and worsening PSI. Case 4; an 85 year old with hypothyroid, painful denuded skin and PSI. Case 5; a 24 year old with pseudomyxoma peritoneal cancer, stomal leakage, painful denuded skin and PSI. All patients received one application of CLKP prior to pouching appliance application.

Results: Case 1; PSI was resolved at day 7 post-CLKP. Case 2; PSI was resolved at day 7 post-CLKP with no additional narcotics required. Case 3; PSI was resolved at day 8 post-CLKP following appliance and pouch modification. Case 4; PSI was resolved at day 2 post-CLKP with pouch adjustment. Case 5; PSI was resolved at day 3 post-CLKP

Conclusion: We conclude that CLKP is an effective option for treatment of patients who present with PSI as a result of their ileostomy or urostomy. Addressing the underlying cause of PSI must also be incorporated. Complete resolution of PSI was observed at 2-8 days post-CLKP.