造口周圍潮濕相關皮膚損傷評估與預防處置策略

Prevention and Management of Moisture-Associated Peristomal Skin Damage

造口周圍潮濕相關皮膚損傷亦稱為造口周圍刺激性皮膚炎，是造口術後最常見的合併症，倘若發生會使造口用具有反覆滲漏危機，引發刺激性皮膚炎的惡性循環，致皮膚嚴重損傷、疼痛與感染負向影響，對病人身心與生活衝擊甚劇。此合併症的發生與病人屬性、造口及造口用具等因素密切相關。執行管理與追蹤及選擇造口用具防堵滲漏，是避免皮膚損傷的關鍵。護理人員應具備造口及其周圍皮膚管理知識與技能，教導病人執行正確造口護理並預防相關損傷發生，維持其生活品質。本文藉由文獻回顧探討造口周圍潮濕相關皮膚損傷發生機轉與相關因素，提供預防與護理措施建議，期待能提供護理人員對相關此議題預防與處置概念並導入臨床應用，以降低造口病人皮膚損傷發生。

Peristomal moisture–associated skin damage, also known as peristomal irritating dermatitis, is the most common complication after an ostomy. Its occurrence causes the pouching system to leak repeatedly, resulting in a vicious circle of irritating dermatitis, which leads to serious skin damage, pain, and infection. These changes have a severely negative on the body, mind, and life of patients. The occurrence of this complication is closely related to factors such as patient attributes, stoma, and pouching system. Therefore, the management and tracking of stoma patients as well as the use of an appropriate pouching system to prevent leakage are the key factors for avoiding skin damage. Hence, nurses should have knowledge and skills for the management of stomas and peristomal skin and the ability to teach patients to perform correct ostomy care, prevent the occurrence of related skin damage, and maintain their quality of life. In this paper, we review the mechanism of occurrence and related factors of peristomal moisture–associated skin damage and suggest measures for prevention and care. We hope to provide nurses with useful concepts related prevention and treatment that can be introduced into a clinical application to reduce the occurrence of skin damage in patients with stomas.