A skin barrier has a significant role in a pouching system. It protects the peristomal skin and holds the pouching system in place. A prerequisite for a skin barrier to work is its compatibility with the peristomal skin. That is why ostomy care companies produce thinner skin barriers to facilitate varying peristomal planes and to provide ample convexity where required. Clinicians must understand how ostomy adhesives and accessory products work. It allows them to help patients pick the right option.
There are several ingredients used in the making of solid skin barriers. Those ingredients include tackifiers, polymers, softeners, plasticizers, hydrocolloids, fillers, and pigment. The methodology of the composition may differ across brands, but ingredients are largely the same.
Tackifiers provide initial adhesion between the skin and the skin barrier. The stickiness of the surface depends on the amount of tackifier used, but it doesn’t necessarily determine the length of use. Stickiness also depends on the pressure applied after the skin barrier is placed over the stoma.
Polymers provide a powerful bond to the skin. The ability of polymers to melt with the body temperature and settle into the creases and crevices of the skin allows them to ensure a tighter and more leak-proof seal between the skin barrier and the peristomal skin. This mechanism of polymers is known as heat-activated adhesion.
Using a skin protectant may be the right option when tape adhesive cause skin stripping, but it might reduce the ability of the skin barrier to adhere to the skin surface. That is why the use of skin protectants has become an outdated solution.
Hydrocolloids consist of carboxymethylcellulose (CMC), pectin, and gelatin. They are known for providing absorption. The primary function of absorptive products is to nullify the effects of perspiration and secretions to ensure the longevity of appliance placement. An adhesive product containing hydrocolloids is generally capable of absorbing metabolic products secreted from the skin while maintaining adhesion. It also prevents fungal and bacterial invasions.
Cohesion, Flexibility, and Shape
The two most crucial characteristics of a skin barrier are cohesion and flexibility. These characteristics help a skin barrier in maintaining a healthy environment under the faceplate to ensure comfort and extended wear-time. A more cohesive product will leave extra residue on the skin. That’s why it is more capable of protecting the skin. Ostomy supplies that come with extended-wear adhesives are more cohesive than standard wear adhesives.
When it comes to assessing the flexibility of the skin barrier, you first need to remove the protective backing. Then, you can apply that skin barrier to your forearm, hand, or abdomen to determine the product’s unique properties related to body contours.
It can be challenging to determine the appropriate shape of the skin barrier. You can assess your abdomen while sitting, moving, lying, and standing. A flexible skin barrier works better than a rigid one.
Clinicians need to understand the concepts behind adhesive technology to eliminate the use of unnecessary products and steps.