Background Preserving the skin’s acid mantle can help reduce the formation of peristomal skin complications (PSCs). Ostomy products should strive to address this ongoing challenge.

Objective We assessed clinical outcomes and ostomy supply use associated with the use of a barrier designed with pH-buffering technology.

Methods This real-world observational user evaluation recruited 440 clinicians from 11 countries to complete an evaluation for 975 ostomates before and after use of a pH-buffering barrier. Evaluations included a validated discolouration, erosion and tissue overgrowth (DET) peristomal skin assessment tool, a peristomal skin pain scale, and scales for satisfaction and likelihood of recommending the product. Ostomy resource utilisation was also recorded.

Results Mean (SD) DET (n=797) and peristomal skin pain scores (n=392) decreased significantly by 1.9 (3.0, p<0.001) and 1.8 (2.6, p<0.001) points, respectively, after using the pH-buffering barrier. The proportion of patients not requiring ostomy accessories increased by 40.2%; half of patients (n=52) on topical peristomal skin medications reduced their usage. Wear times increased for 38.0% of patients (n=900). Most respondents were satisfied or highly satisfied with the barrier (88.2%, n=952) and likely or highly likely to recommend it (86.4%, n=960).

Conclusions Peristomal skin health and pain levels significantly improved, barrier wear time increased, and topical peristomal skin medication and accessory use decreased after utilising the pH-buffering barrier. These findings on healthcare resource utilisation suggest the pH-buffering barrier provides benefits beyond addressing the clinical burden of an ostomy.

Performing stoma surgery is often complex for the surgeon to undertake especially when the patient has pre-existing complications. Postoperatively, peristomal complications affect the adherence of the collection bag, and impair the self-care and wellbeing of the person with an ostomy, which increases the need for professionals trained in the management of peristomal skin complications. In addition, health professionals need to be able to educate the ostomate in self-care of the stoma or support them in managing peristomal complications. The aim of this case study is to report the management of a complex clinical case of a patient postoperatively following a herniorrhaphy and construction of a colostomy that resulted in surgical dehiscence and ensuing peristomal complications. The case study also highlights the clinical care advocated by the stomal therapist to manage these complications.

Introduction Pemphigus vulgaris (PV) is a severe autoimmune bullous dermatosis resulting in the formation of intraepidermal blisters affecting the skin and mucous membranes. Epidemiologic data shows an incidence of 0.1–0.5 per 100,000 inhabitants per year, and mortality at almost 5–10%.

Objective The objective of this integrative literature review was to examine the classification/terminology of PV ulcers according to the description of skin lesions.

Method This is an integrative review of primary studies, series/clinical reviews or validation studies that describe or evaluate PV ulcers. Search strategies included relevant papers that were published between 2011–2019 using terms such as pemphigus, skin ulcer, dermatology, diagnostic, nursing assessment. The studies were selected for analysis after application of eligibility criteria and exclusion by duplicity.

Results The initial search resulted in 2,934 publications; 14 articles were eligible for analysis. The synthesis of the studies was organised as follows – 57.14% series/clinical reviews, 50% written by physicians, 64.29% level of evidence 4. The terminology used to describe PV ulcers included skin/mucosal erythema, new erythema, post-inflammatory hyperpigmentation, oral lesions, epithelialisation scabs, blisters, bullae, erosions, eroded areas, erosive exudative lesions, dry erosive.

Conclusions Studies with better levels of evidence are needed on this issue in order to determine the best way to describe the lesions using the dermatological glossary for nursing assessment.

Broad and deep perianal wounds are challenging in both adult and pediatric ICUs. These wounds, if contaminated with gastrointestinal flora, can cause invasive sepsis and death, and recovery can be prolonged. Controlling the source of infection without diverting stool from the perianal region is complicated. The option of protective colostomy is not well-known among pediatric critical care specialists, but it can help patients survive extremely complicated critical care management.

These authors present three critically ill children who required temporary protective colostomy for perianal wounds because of various clinical conditions. Two patients were treated for meningococcemia, and the other had a total artificial heart implantation for dilated cardiomyopathy. There was extensive and profound tissue loss in the perianal region in the patients with meningococcemia, and the patient with cardiomyopathy had a large pressure injury. Timely, transient, protective colostomy was beneficial in these cases and facilitated the recovery of the perianal wounds. Temporary diverting colostomy should be considered as early as possible to prevent fecal transmission and accelerate perianal wound healing in children unresponsive to local debridement and critical care.