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Peristomal Moisture–Associated Skin Damage in Adults With Fecal Ostomies: A Comprehensive Review and Consensus

Gray, Mikel; Colwell, Janice C.; Doughty, Dorothy; Goldberg, Margaret; Hoeflok, Jo; Manson, Andrea; McNichol, Laurie; Rao, Samara

Journal of Wound, Ostomy and Continence Nursing: July/August 2013 - Volume 40 - Issue 4 - p 389–399
doi: 10.1097/WON.0b013e3182944340

Approximately 1 million persons living in North America have an ostomy, and approximately 70% will experience stomal or peristomal complications. The most prevalent of these complications is peristomal skin damage, and the most common form of peristomal skin damage occurs when the skin is exposed to effluent from the ostomy, resulting in inflammation and erosion of the skin. Despite its prevalence, research-based evidence related to the assessment, prevention, and management of peristomal moisture-associated skin damage is sparse, and current practice is largely based on expert opinion. In order to address current gaps in clinical evidence and knowledge of this condition, a group of WOC and enterostomal therapy nurses with expertise in ostomy care was convened in 2012. This article summarizes results from the panel's literature review and summarizes consensus-based statements outlining best practices for the assessment, prevention, and management of peristomal moisture-associated dermatitis among patients with fecal ostomies.

Mikel Gray, PhD, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Professor and Nurse Practitioner, Department of Urology, University of Virginia, Charlottesville.

Janice C. Colwell, MS, RN, CWOCN, FAAN, Advanced Practice Nurse–Ostomy, Care Services University of Chicago, Chicago, Illinois.

Dorothy Doughty, MN, RN, CWOCN, FNP, FAAN, Director, Wound Ostomy Continence Nursing Education Center, Emory University, Atlanta, Georgia.

Margaret Goldberg, MSN, RN, CWOCN, Delray Medical Center, Delray Beach, Florida.

Jo Hoeflok, RN (EC), BSN, MA(LS), CETN(C), CGN(C), Advanced Practice Nurse for Gastroenterology and General Surgery, St. Michael's Hospital, Toronto, Ontario, Canada.

Andrea Manson, RN, BSN, ET, Care & Supply Centre, New Westminster, British Columbia, Canada.

Laurie McNichol, MSN, RN, GNP, CWOCN, Director, Clinical Nurse Specialist/WOC Nurse, Cone Health, Wesley Long Hospital, Greensboro, North Carolina.

Samara Rao, BScN, RN, CETN(C), Alberta Health Services Royal, Alexandra Hospital, Edmonton Alberta, Canada.

Correspondence: Mikel Gray, PhD, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, PO Box 800422, Charlottesville, VA 22908 (

All authors act as clinical advisors for the Hollister Peristomal Skin Care Working Group.

© 2013 by the Wound, Ostomy and Continence Nurses Society.