Kelly VICKERS, RN1
1Stomal Therapy Nurse, Clinical Practice Consultant, Lyell McEwin Hospital, Haydown Road Elizabeth Vale, South Australia, 5114, kelly.vickers@sa.gov.au
Introduction: VAC Therapy has become an integral part of wound care and management around the world. It can be beneficial in healing a variety of wounds including surgical, ulcers, skin grafts, burns, diabetic feet & fistulae. Peristomal skin trauma from erosion and faecal irritant dermatitis, by definition is a wound, so implementing VAC Therapy could ideally promote its healing.
Background: A 55-year-old female underwent a High Anterior Resection and formation of a loop ileostomy for chronic diverticulitis and abscess formation. Her post-operative recovery was complicated from frequent appliance leakages resulting in severe peristomal skin erosion. Factors such as retracted stoma positioning, obesity (BMI 44kg/m2), large skin creases, high output, dehydration and electrolyte disturbances all contributed.
Method: A wide variety of appliances, accessories and techniques were implemented to manage the challenging factors, with sporadic success. Bag leakages ranged from occurring every 0.5 – 16.5 hours, leading to severe and painful peristomal skin erosion.
This case study outlines the challenges encountered, and the implementation, management and treatment plan of VAC Therapy to the peristomal skin erosion.
Conclusion: With the implementation of VAC Therapy, the patient was able to improve her mental, emotional and physical well-being, which had been negatively impacted from all the stomal complications she had endured. She was able to leave the hospital on day leave regularly and although she was not discharged home prior to reversal, successful use of VAC Therapy to heal her peristomal skin erosion, made the final few weeks leading to this better quality.
Key Words
VAC Therapy, Peristomal skin, erosion
Biography
Have practised as a Surgical Registered Nurse for 12 years at an Adelaide Northern Suburbs Tertiary Hospital. Became a fully qualified Stomal Therapy Nurse in 2008, and commenced employment as Stomal Therapy Clinical Practice Consultant. Areas of practice cover stomas and wound in both inpatient and outpatient setting. Active full member of AASTN SA Branch.