Dermatologic changes in the circumileostomy skin.

A comprehensive questionnaire inquiring about difficulties with care of the skin in the area immediately surrounding the artificial anus was sent to ileostomy patients in the United States. Eighty per cent of 327 replying to the questionnaire had such difficulties. The problem of irritation is essentially that of intimate contact of fecal material with the circumileostomy skin, and associated factors are the potentially irritating materials used in the manufacture of ileostomy appliances, as well as the adhesives used to affix the appliance to the skin. Mechanical trauma incident to removal and reapplication of the appliance, as well as loosening of the disc and exposure of unprotected skin, accelerates the corrosive action of the material discharged. Changing the appliance before leakage or irritation occurs is helpful in preventing skin difficulties.In cases of long standing or repeated irritation, care must be taken to check the suitability of the appliance or the possibility of a complication in the stoma that could be corrected surgically.