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May 1964

Circumileostomy Skin Difficulties: A Study in Great Britain and the United States

Author Affiliations


Department of Dermatology, Stanford Medical Center.

Arch Dermatol. 1964;89(5):675-677. doi:10.1001/archderm.1964.01590290041006

A total of 597 replies were received from a questionnaire survey made in Great Britain. Together with a group previously received from the United States, this gives a total of 1,048 ileostomy patients from which the material for this paper was taken. Eighty-two per cent of those replying from Great Britain reported skin difficulty of varying degree in the circumileostomy area; 76% of the group from the United States reported circumileostomy difficulty.

The two groups were similar in many respects. The primary cause of skin irritation was leakage of intestinal fluid on unprotected skin. Various devices for collecting the fluid have been used but a completely satisfactory appliance unit has yet to be found. A particular problem was the necessity of cementing the appliance to the abdominal wall. A nonirritating, long lasting, cosmetically suitable cement is needed.

The treatment of recurrent skin difficulty was mainly that of acute or chronic dermatitis. Karaya gum powder was used to provide a temporary adhesive while weeping, painful dermatitis was healing. Patients learn by experience and pass information on to newer ileostomy patients through ileostomy clubs.

The problem of skin difficulty in the circumileostomy area continues to be of major interest in the postsurgical patient.1,2 In previous publications3,4 we have reported on the prevalence and characteristics of circumileostomy irritation in a total of 451 patients located in the United States. The purpose of this report is to tabulate the results of a survey conducted among ileostomy patients in Great Britain. The number of patients reporting from Great Britain was 597. Whenever applicable, the totals of the two surveys were combined, giving a sum total of 1,048 patients for analysis.