Peristomal Protection: A Peep into the Future Changing Technology
Creation of a stoma in the abdominal wall is a major challenge to patients not only physically but also emotionally. Stomas are primarily created through surgeries namely ileostomy, colostomy or urostomy, as a temporary or permanent solution for some diseases and conditions like colorectal cancer, ulcerative colitis, and Crohn’s disease. There is a wide range of products available for ostomy care. Some of these products include ostomy bags, skin barriers, deodorants, irrigation products and other care accessories. According to IQ4I analysis of Incontinence and Ostomy Care Global Market, Ostomy Care Global Market was estimated to be $2.4 billion in 2016 growing at mid single digit CAGR.
A major concern of ostomy patients is the peristomal skin complications. As we already know skin acts as a barrier that protects the body from the risk of developing an infection. Creation of a stoma is like breaching this protective barrier. Apart from the body being at risk of infection, the skin around the stoma is also at risk of damage. The peristomal skin damage can cause a wide range of signs and symptoms, from skin discoloration to polyp-like growths, from erythema to full-thickness wounds. Thus, the peristomal skin needs scrupulous care to maintain its health.
In conventional stoma surgery, the intestine is extended a few centimeters outside the abdominal wall, ending in a stoma bag that adheres to the skin. Most peristomal skin damage is either caused due to the adhesive on the wafer or skin barrier. These skin barriers ensure the excreted products of the stoma opening is collected into the ostomy bag and reduces the risk of the excreted material leaking onto the skin that may result in infection and damage to the peristomal skin. As every stoma is different, to ensure the collection is leak proof a wide variety of products with varying sizes and fit are available. Some bags come with the wafer attached (one-piece ostomy bags) while others require both the wafer and the bag to be bought separately (Two-piece ostomy bags). About 55% ostomy patients prefer the use of two piece bags as the wafer need not be removed from the skin every time when the bag needs to be changed. This reduces the mechanical damage caused by the removal of the adhesive wafer more often as in the case of one-piece ostomy bags.
Every ostomy product manufacturer spends substantial amount for research and development to ensure development of innovative products that can address the current issues faced by ostomy patients. For example, Convatec has taken another step towards improving the fit of skin barrier onto the stoma by developing the mold-to-fit type of skin barrier like Sur-Fit Natura that is made up of a flexible and stretchable material called Durahesive. This skin barrier swells around the stoma on contact with liquid and forms a turtle neck securing the stoma from leakage. This is available in both flat and convex type in a two-piece ostomy system.
Another revolution in ostomy care technology is introduction of Transcutaneous Implant Evacuation System (TIES) by OstomyCure. CE approved TIES is an implant for ileostomy patients. The implant consists of a small tube made of pure titanium surrounded by a porous structure which allows smooth integration with the body tissues. This system is a result of the latest 3D manufacturing will replace the conventional procedure of ostomy surgery, wherein the implant is placed at the stoma instead of the intestine directly attaching to the abdominal wall. The implant can be sealed with a lid on the outside that the patient can open to drain the waste whenever necessary instead of having to adhere an ostomy bag continuously throughout the day and night, giving the patient more control and improving their quality of life. This system reduces the mechanical damage caused by the adhesive on the wafer as well as ensures no leakage of the excreted material onto the skin.
With the existing technology like Convatec’s moldable technology and the upcoming TIES system, ostomy patients will be relieved of not only peristomal complications but also will see a drastic change in the quality of life.