Use of Hyaluronic Acid–Based Filler to Prevent Ostomy Pouch System Leakage

BACKGROUND: An ileostomy is a commonly performed procedure in patients with various gastrointestinal conditions. A portion of small bowel (ileum) is brought through the anterior abdominal wall via a surgical opening called a stoma where fecal effluent is collected in an ostomy pouching system. The procedure is associated with potential complications including parastomal herniation, undermining and leakage of the ostomy pouching system, and peristomal skin damage. Leakage under the ostomy pouch system is initially treated conservatively with interventions for skin protection, such as skin barriers, adjusting the fit of the skin to accommodate ostomy size, convexity and an ostomy belt. If conservative measures are unsuccessful, more invasive procedures, such as dermal fillers, may be implemented. CASE: A 42-year-old woman with a history of ulcerative colitis (UC) and an ileostomy experienced recurrent ostomy pouch leakage. This case describes a previously unreported treatment approach using hyaluronic acid (HA)–based filler for managing leakage secondary to scarring and concave areas in the peristomal skin. The use of HA-based fillers improved the adhesion of her ostomy pouch system, resulting in decreased leakage and peristomal irritant contact dermatitis. CONCLUSION: Use of HA-based filler for scarring and concave areas of Ms T’s peristomal skin allowed longer ostomy pouching system wear time without leakage, improving her symptoms and health-related quality of life. Further studies are needed to investigate the long-term effectiveness of this procedure and compare outcomes to other types of fillers for peristomal skin.