1. Skin Care

The patient is able to state measures to maintain perianal skin integrity.

Looseness and frequency of stool is not uncommon during the early months following pelvic pouch surgery. It generally takes at least six months for the pouch to "adapt" - begin functioning and acting like a pouch or reservoir. It is extremely important to keep the skin around the anus clean, dry and intact.

Suggestions to maintain perianal skin integrity:

• Cleanse and dry the skin thoroughly following each bowel movement or mucous discharge.

• Moistened soft tissues or cotton balls are ideal for cleansing the skin and are less abrasive than ordinary tissue.

• No-rinse cleansers are also very effective.

• Warm water is generally all that is needed. Soap tends to dry the skin and may leave a residue resulting in itching.

• Pads or panty-liners should be changed frequently to keep the skin clean and dry

• Cotton underwear rather than nylon or polyesters are advisable. Cotton absorbs perspiration and allows air to circulate.

• Skin barrier creams (ProShield™, Desitin™, Penaten™, PeriCare™, Cavilon™) are soothing and add a layer of protection for irritated skin. Barrier creams should be applied following each movement and used until stool numbers decrease and stool consistency becomes thicker.

• Sitz baths are a gentle, thorough way to cleanse and soothe irritated skin and may follow each movement.

If the skin should be become reddened, broken or itchy, assessment by the family doctor, or outpatient ET nurse is advisable. A fungal infection can occur because of moisture if left untreated. If suspected, this should be assessed by a professional.

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