Care and treatment of peristomal gangrenous pyoderma. A study of three cases
| Autor: | Francisco Villalba-Ferrer, Blai García-Costa, Leticia Julve-Herraiz, María José García-Coret |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Triamcinolone acetonide Skin infection Inflammatory bowel disease Tacrolimus Stoma 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine Abscess Wound Healing business.industry Surgical Stomas General Medicine Inflammatory Bowel Diseases medicine.disease Dermatology Pyoderma Gangrenosum Peristomal Skin 030211 gastroenterology & hepatology Clobetasol propionate business medicine.drug |
| Zdroj: | Enfermería Clínica (English Edition). 31:120-125 |
| ISSN: | 2445-1479 |
| DOI: | 10.1016/j.enfcle.2020.11.001 |
| Popis: | Peristomal gangrenous pyoderma is an inflammatory skin disease with progression to painful ulcer, rare, and rarely associated with colorectal carcinoma. Its diagnosis is differential since it can be confused with skin infection, abscess, contact dermatitis, peristomal irritation or peristomal skin extension of an inflammatory bowel disease. We present three cases of patients operated for colorectal carcinoma with an intestinal stoma, who developed peristomal gangrenous pyoderma. A plan of local care and dressings was developed using the NANDA, NOC and NIC taxonomies. Stoma care and fitting of collecting devices were performed with saline solution, paste, ostomy powders and a two-piece bag. For the basic local treatment, physiological serum or washing solution was used for wound cleaning, aqueous eosin (2%), alginate in the exudative phase, and collagenase ointment in the presence of slough/necrosis. Specific local treatment (clobetasol propionate, tacrolimus, or triamcinolone acetonide infiltration) and systemic treatment (corticosteroid therapy) was given sequentially after the diagnosis of peristomal gangrenous pyoderma depending on the clinical response to each treatment. Case 1 resolved at six months with a good response to local triamcinolone infiltration. Case 2 resolved at 10 months after local infiltration with triamcinolone and oral prednisolone. Case 3 had no response to local treatments or systemic corticosteroid therapy, healing after tumour and metastatic excision with relocation of the stoma at nine months. |
| Databáze: | OpenAIRE |
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