At this year’s forthcoming ASCRS conference we will be presenting our data on the use of thermal imaging in monitoring for skin issues in ostomates. Dr Saahil Mehta, a plastic surgeon, provides his analysis here ahead of the conference.
Living with a stoma has its challenges. For any new patient with a stoma, there is an adjustment period. It is both physically and mentally about living with a piece of externalized bowel on your abdomen. We must always remember that ostomies can improve a patient’s quality of life immensely and can allow a patient to manage their disease rather than have the disease manage them.
Ostomies bring their own complications with up to 72% of patients reporting both short and long-term problems. The most prevalent complication one year after surgery is peri-stomal skin problems which translates to “problems with the skin around the stoma.” These skin problems range from simple irritation, dermatitis, infections, and skin blistering that causes superficial skin loss. Living and dealing with these issues can be painful and frustrating for patients and stoma care nurses. Unlike certain parts of the body (soles of your feet or the skin of your lips), abdominal skin is not developed for either the recurrent trauma or sensibility that wearing a stoma bag will require.
Skin and wound health occupies its own realm in the medical field that most general surgeons and creators of ostomies understandably have little experience in. The health of the skin falls under the expertise of the dermatologist, tissue viability nurse, and the plastic surgeon. It would make sense to collaborate with these other subspecialists to attempt to reduce peri-stomal skin issues.
Much work has been done looking at the relationship between skin health and temperature. There is good evidence in the medical literature that changes of between 0.5-2°C in skin temperature indicate changes in skin health. If we look deeper into what is happening at an epidermal level (the most superficial layer of the skin), we can correlate these skin temperature changes with changes in epidermal blood flow from the underlying, complex and tiny dermal plexuses of blood vessels.
What does this mean for the ostomy patient and how can this information benefit them? Ask any plastic surgeon what is needed to get a wound to heal properly and they will say, “blood flow.” Ask any general surgeon and they will say, “ask the plastic surgeon!” What if we could measure the skin temperature of the peri-stomal skin and correlate this with the health of the skin? To take it further, what if we were able to predict impending skin problems by tracking skin temperature changes over time?
At 11 Health, we are doing just that. We now have the capability to measure and plot peri-stomal skin temperature over time and correlate these observations with overall skin health. We are working with a plastic surgeon to understand how we can better predict and prevent skin problems for the benefit of all ostomy patients. Ultimately, we want to create a paradigm shift from “predict and prevent” to “realize and react.”
Dr. Saahil Mehta is a Plastic Surgeon in the UK and his research interest involves skin healing and heat therapy. He is currently working as Clinical Director and Innovation Lead at 11 Health Technologies in California to understand the relationship between skin health and temperature.
Click to see our abstract on the ASCRS site here (abstract P221 on page 257).