Information about the difficulties which may occur in the skin around the ileostomy outlet was obtained from 451 patients. Dermatitis was reported by 58 % of this group; it generally occurred in the early postoperative period (6-12 weeks). The high incidence was ascribed to the prolonged contact of the usually unprotected skin with the ileostomy effluent. The epithelium underlying the ring used to attach the collection bag to the skin was commonly irritated or excoriated by pressure or by adhesive agents. A stoma opening flush with the skin invariably caused irritation, but ileac stumps that were too long were liable to trauma. An ileac stump about 2 cm. in length appeared to be optimal. Karaya powder was reported as helpful by many patients in developing individual techniques of skin care. Many of the patients who had least difficulty in adjusting to and caring for their ileostomies reported "ileostomy clubs" as the best source of help.
McNamara RJ, Farber EM, Roland SI. PROBLEMS AND TREATMENT OF THE CIRCUMILEOSTOMY SKIN. JAMA. 1959;171(8):1066–1072. doi:10.1001/jama.1959.03010260022005
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