Keywords

moisture-associated skin damage, ostomy, peristomal complication, peristomal skin, pseudoverrucous lesions, quality of life, urinary stoma

 

Authors

  1. Brogna, Luanne MSN, RN, CWOCN

Abstract

GENERAL PURPOSE: To present the associated risk factors, prevention measures, and assessment and management of pseudoverrucous lesions specific to a surgically created ileal conduit, as well as three clinical scenarios illustrating this condition.

 

TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

 

LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:

 

1. Define pseudoverrucous lesions.

 

2. Identify the risk factors for stoma complications such as pseudoverrucous lesions.

 

3. Select the appropriate routine care procedures to teach patients following stoma creation to help prevent pseudoverrucous lesions.

 

4. Choose the recommended treatment options for patients who develop pseudoverrucous lesions.

 

ABSTRACT: Pseudoverrucous lesions are a late peristomal complication that occurs most commonly in people with urinary stomas. Impairment of the peristomal skin can result in pouching system leaks that can translate into odor, embarrassment, and diminished quality of life. Prevention is key to maintaining smooth, dry skin and intact psyche. Treatment revolves around outpatient postoperative follow-up, refitting the pouching system to eliminate moisture impacting the peristomal area, modification of pouching system wear time, acidification of the urine, and intensive education. This review includes three case scenarios to support early, intermediate, and late-stage intervention guidelines. Some interventions were successful; one case remains unresolved.