Moisture-Associated Skin Damage: Expanding Practice Based on the Newest ICD-10-CM Codes for Irritant Contact Dermatitis Associated With Digestive Secretions and Fecal or Urinary Effluent From an Abdominal Stoma or Enterocutaneous Fistula.
Laurie McNichol, Donna Z Bliss, Mikel Gray
PMID 35523238WHAT IT FOUND
Irritant dermatitis around stomas and fistulas is common and is now coded by the moisture source.
Nurses should assess effluent type, protect skin, secure tubes, fit pouches, and avoid upsizing leaking tubes.
Key findings
01Up to 80% of individuals with an ostomy experience peristomal skin complications, and irritant contact dermatitis is the most prevalent.
02For urinary stomas, alkaline urine can provoke peristomal inflammation, and urine pH should be kept below 7.0.
03Tube movement is postulated as the most frequent factor contributing to irritant contact dermatitis around gastrostomy or jejunostomy tubes, and replacing a leaking tube with a larger-diameter tube is contraindicated.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It is a narrative review, not a trial, so it does not test whether the recommended skin care or pouching changes improve outcomes. It does not describe a search or appraisal method, so the evidence base behind its recommendations is not transparent. It does not report patient outcomes from a defined population, so prevalence statements are summaries of other studies.
The easy way to misread this
Do not read the recommended skin and pouching steps as evidence they work. This article does not report a trial or outcome comparison.