Background Healthy skin around an open stoma in colostomy patients is exposed to a humid environment and the acidity of the faeces. This condition can produce periostomal skin problems such as very painful ulcers, with difficult pain management. Chitosan is a biodegradable polymer and has an important role in clinical practice.
Purpose To evaluate the efficacy of chitosan film in a patient with refractory pain caused by a periostomal ulcer.
Material and methods Film preparation: chitosan was diluted in sterile water to a final concentration of 2% at 70°C and mixed with a magnetic stirrer. 0.2 mL of acetic acid glacial were added slowly to form a semisolid gel. The gel was allowed to dry in a plastic solid base for 24 hours at room temperature protected from UV light to form a film. Efficacy was measured on: a visual analogue scale for pain (VAS pain), the Clinical Global Impression-Global Improvement (CGI-I) Scale and the reduction of dose or withdrawal of analgesic medication base.
Results A colostomy patient presented with painful conditions refractory to conventional analgesic therapy. The patient was aged 68 years (76 kg and 168 cm). Chitosan film was applied above the periostomal ulcer and we placed a stoma disk on the abdomen. The patient was receiving magnesium metamizole rescue (575 mg three times per day) until treatment with chitosan film, resulting in no rescue magnesium metamizole on the second day of initiating therapy. VAS pain score before the chitosan film was 9 and remained at 2 for 48 hours after application of the film, achieving a score of 2 on day 1. CGI-I Scale score at the end of treatment was 1 (denoting great improvement). The patient had no changes in clinical parameters. The total rinsing treatment duration was 4 days, requiring only two rinses the first day. Cessation of pain occurred within 15 min after film application.
Conclusion Chitosan 2% film showed complete efficacy in our periostomal patient with painful conditions refractory to standard analgesic therapy. Further studies are needed to strengthen our results.
References and/or acknowledgements TO ENCARNA LACASA.
No conflict of interest
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