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Use of Ilex skin protectant A study within the stoma care department at Pilgrim Hospital

By Deputy Sister Sarah Hill and Deputy Sister Debra Pycock

Reasons for carrying out Audit

• Following recent study days, information on ilex received and told of its benefits for sore skin.
• Felt may be an added tool for treatment for our patients.
• Contacted Tissue Viability Consultant nurse, a small audit study needed of 10 patients to assess how effective the product is.
• Obtained sample tubes and sachets of ilex from Oakmedrep to carry out the study. 

Good response in Paediatric patient

• At a paediatric study, day told that ilex can be used for babies and children that may have excoriated bottoms following reversal of stoma for imperforate anus.
• Mum of a baby who had undergone reversal phoned to say her son’s bottom was very sore and had tried lots of different creams with no success.
• Suggested use of ilex cream and sample tube sent. Instructions given to only apply a thin layer and then cover with a layer of vaseline to avoid nappies sticking. Only need to reapply once daily and not at each nappy change. For removal may need to use some baby oil.
• Follow up call –area of excoriation much improved.

When to use iLEX skin protectant

• Ulcers / broken areas. Would suggest this can be used as a first-line treatment.
• Granulomas that have clustered at the mucocutaneous junction causing redness and pain.
• Sore /red excoriated skin. Only try ilex when have used other treatments such as skin barriers, powder, seals, different pouch with no effect.

Advice on how to use Ilex

If applying ilex to the skin underneath the pouch such as on an ulcer 

1. Swab the ulcer to check for infection.
2. Clean the skin and dry as usual.
3. Apply a dusting of orahesive powder.
4. Apply a very thin layer of ilex cream. It is quite thick and difficult to manoeuvre but only need a thin layer.  Do not use too much.
5. Apply a dusting of orahesive powder over the top.
6. Apply the pouch as usual
7. May need to hold longer to ensure the pouch has stuck well.
8. Can cut template large r if required.

If applying ilex to the  skin immediately around the stoma

1. Clean and dry the peristomal skin as usual
2. Apply a thin layer of ilex to the skin affected
3. Cut the template larger so that the cream is exposed.
4. Apply pouch as usual

Conclusions to the audit

• From using ilex on 10 patients a good response was achieved by some of the patients.
• Ulcers were healed, pain scores reduced and peristomal skin areas improved.
• Need to gather more evidence on its use so to still continue to use audit sheets and take photographs to note improvement.
• Based on results tissue viability nurse consultant has allowed us to obtain stock of ilex through RDC.
• Sample tubes will last the patient a good 2 weeks as only a small amount required.
• When needing to order a larger tube of ilex IP51 (57g), it can be done as though ordering any other product.  Alternatively can be ordered through Oakmed gold delivery service if only ilex is required.

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