Management of Peristomal Skin Complications with Negative Pressure Wound Therapy: A Case Study

Abstract

Aim: Estimate the effectiveness of the Negative Pressure Wound Therapy (NPWT) into managing a complex peristomal skin complication in a patient with a urostomy. The goal was to improve the conditions of the skin in order to concede stoma management with the appropriate ostomy device. The clinical condition of the patient was exasperated by her overall status: advanced neoplasia, skin deterioration and diabetes. Methods: The subject had a urostomy (Wallace 2) caused by advanced bladder cancer; she presented a peristomal skin lesion L4-TV according to Studio Alterazioni Cutanee Stomali (Study on Peristomal Skin Lesions [SACSTM Instrument]). The treatment with advanced dressings as per current protocol did not improve her clinical status. After this phase the subject was treated with Negative Pressure Wound Therapy. A total of four dressings were changed every 72 hours. Results: In just 12 days the skin lesion improved greatly to L3 / T1-T4; this allowed correct management of the stoma with the appropriate ostomy device for the following month. During follow-up visits we appraised a day to day improvement of her peristomal skin condition. The medication was very well received by her; no negative effects nor did intolerance occur. Conclusions: This case study allowed us to observe the use of Negative Pressure Wound Therapy as an effective substitute treatment in case of difficult peristomal skin lesions. The technique is safe, efficient, moneysaving and comfortable for patients.

Recent Advances and Applications of Bacterial Cellulose in Biomedicine

“…The SCOBY then ferments a tea solution which results in a beverage high in probiotics. Bacterial cellulose has also been used a meat-free option for vegetarians, due to its structure, as well as being used a high fibre dietary supplement [ 88 ].…”

“…Bacterial cellulose was soaked in 5% lidocaine solution and subsequently soaked in an ethanol solution [ 129 ]. Following diffusion assays, lidocaine was released at a low steady rate, while ibuprofen release at three times the rate of commercially available dressings with similar concentrations of [ 88 ]. Diclofenac was loaded onto bacterial cellulose by soaking the cellulose in glycerol containing 5% diclofenac, which displayed a swelling ratio six times higher than in pure bacterial cellulose.…”