Adapted Crusting Technique in Children with Peristomal Lesions: A Case Series
Ana Cristina Santos Monteiro1, Maria Lucia Barbosa Maia Dos Santos, Marcia Aparecida Souza
1At the Children's Institute, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Brazil, Ana Cristina Santos Monteiro, RN, is a stoma therapist; Maria Lucia Barbosa Maia dos Santos, MS, RN, is Head Nurse, Pediatric Intensive Care Unit; Marcia Aparecida Souza, RN, is Nurse Referee of Hospital Medical Records; and Juliana Caires de Oliveira Achili Ferreira, PhD, is Clinical Research Center Coordinator. The authors have disclosed no financial relationships related to this article. Submitted January 13, 2020; accepted in revised form March 9, 2020.
Insights
A novel adapted crusting technique effectively treated pediatric peristomal lesions in a Brazilian ICU. This method improved patient outcomes and may reduce healthcare costs.
Area of Science:
- Pediatric critical care medicine
- Wound healing and ostomy care
Background:
- Peristomal lesions are a common complication in pediatric patients with gastrostomies.
- These lesions can cause pain, discomfort, and complicate patient care.
Purpose of the Study:
- To describe the application and effectiveness of a systematic single adapted crusting technique for peristomal lesions in pediatric intensive care unit (PICU) patients.
- To evaluate the impact of this technique on healing and patient outcomes.
Main Methods:
- Retrospective analysis of six pediatric cases with traumatic, noninfectious peristomal lesions and gastrostomy-related gastric residual leaks.
- Standardized treatment using a single adapted crusting technique applied over 7 to 15 days.
Main Results:
- All six patients demonstrated significant improvement in peristomal lesions within 48 hours of treatment.
- The observed healing was attributed to the adapted crusting technique, as recommended by ostomy professionals.
Conclusions:
- The adapted crusting technique proved effective in managing peristomal lesions in pediatric patients.
- This intervention shows potential for improving patient safety, reducing pain, decreasing nursing workload, lowering hospital costs, and enhancing quality of life.
Objective:
To describe the care of pediatric patients who had a gastrostomy and developed peristomal lesions and received a systematic single adapted crusting technique in a pediatric ICU in a tertiary Brazilian hospital.
Methods:
An analysis of six cases presenting traumatic, noninfectious peristomal lesions with ostium enlargement resulting in gastric residual leaks. All six patients received the same treatment over 7 to 15 days.
Results:
Lesion improvement was observed in all patients after 48 hours and considered attributable to the standard treatment recommended by ostomy professionals.
Conclusions:
The adapted crusting technique was effective in the treatment of children with peristomal lesions. This technique may be beneficial to other patient and organizational outcomes such as improving safety of care, decreasing pain and discomfort, reducing nursing workload and hospital costs, and improving quality of life.
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