Understanding the Impact of Ostomy Dejecta Constituents on Peristomal Skin Health and Models for Its Characterisation

ABSTRACT

An ostomy, or stoma, is a surgically created percutaneous aperture from a hollow organ (e.g., small intestine) to the body's surface. Physicians may recommend an ostomy as a temporary or permanent solution to a range of disorders of the gastrointestinal tract, with up to 130 000 ostomies performed annually in the United States. An ostomy facilitates the expulsion of waste products, termed dejecta and circumvents the compromised organs. While an ostomy can be a lifesaving treatment, it is a disruption of regular digestive flow and has a number of associated complications including hernia, prolapse and necrosis. The most commonly observed complications are peristomal skin complications (PSCs), attributed to the leakage of dejecta onto the peristomal skin or the skin directly surrounding the stoma. Despite the prevalence of PSCs, little is known about the precise etiological factors that play a role in PSC formation. This review discusses the constituents of dejecta and their possible roles in PSC formation. Additionally, we identify a number of in vitro and in vivo skin models that could be used to study PSCs. Identification of the components of dejecta and understanding their interaction with skin models can facilitate the development of interventions to treat and prevent PSCs.