Published in:
01-10-2007 | Case Reports
Paraileostomy Recontouring by Collagen Sealant Injection: A Novel Approach to One Aspect of Ileostomy Morbidity. Report of a Case
Published in: Diseases of the Colon & Rectum | Issue 10/2007
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Introduction
Poorly fitting stoma appliances, resulting in stomal leakage and subsequent skin excoriation, remain a significant cause of ileostomy-related morbidity. One cause of ill-fitting stoma bags is the presence of parastomal dermal contour defects/irregularities. These may occur after surgical complications or change in patient weight and body habitus.
Methods
We report the case of a 29-year-old man who, after panproctocolectomy and formation of ileostomy for ulcerative colitis, experienced significant problems with stoma bag application because of dermal contour defects. As a result, he suffered from significant stomal leakage and skin excoriation. After a single treatment of cutaneous parastomal infiltration of porcine collagen (Permacol™ Injection), applied stoma bags achieved a watertight seal, and the patient experienced complete and sustained resolution of his symptoms.
Conclusions
Porcine collagen is a safe, versatile, and relatively easy method of restoring irregular skin defects surrounding abdominal stomas, thus resolving the significant patient morbidity associated with ill-fitting stomal appliances. Such a technique avoids the need for surgical stoma refashioning, which may be associated with significant morbidity and unsatisfactory outcomes.