Peristomal Skin Integrity of Patients with Tracheostomy

Purpose: Study was carried out to determine  effect of barrier cream on peristomal skin integrity. 

Background: Patients with tracheostomia are facing new problems every day. Among care problems and complications one of the big issues patients have to get over is to maintainthe peristomal skin integrity

Methods: Study was conducted as a quasi-experimental study between the dates March-December 2013, in a university hospitals’ inpatient unit in Ankara, TURKEY. Sample consisted of 60 patients (randomly assigned 30 patients for control group and 30 for intervention group), aged between 18-65 years, and admitted to inpatient clinic without tracheostomy complications. Both control and intervention group patients were given peristomal care skin care 3 times a day for 7 consecutive days by researcher. Barrier cream and gauze dressing over the cream was applied as an intervention in the study to maintain the skin integrity and gauze dressing was applied to peristoma in control group to maintain the skin integrity. 

Peristomal skin pH, temperature and moisture level were assessed to determine the effectiveness of both application (gauze and barrier cream-gauze) to maintain the skin integrity. Ethical approval was obtained from the Ethical Committee of Hacettepe University. Written permission was obtained from the directors of the hospital and patients. Data were evaluated by analysis of variance for repeated measures, mean and percentage calculations.

Results: Both control and intervention group patients' peristomal skin integrity were maintained after 7 days of care and their peristomal skin pH, temperature and moisture levels were found in normal ranges. Difference between peristomal skin PH,  temperature and moisture level of two groups were found statistically significant.  

Conclusion: It can be concluded that both gauze dressing and barrier cream - gauze dressing changes over peristoma preserve the skin integrity. However, results indicate that barrier cream - gauze dressing application is better for balancing the peristomal skin's pH, humidity and temperature level with in normal ranges.