What is the role of gelonet in stoma care?

Gelonet in Stoma Care: Role and Applications

Gelonet is not specifically mentioned or recommended in current stoma care guidelines or literature as a standard product for stoma care, as it is primarily a paraffin gauze dressing typically used for burn wounds rather than a specialized stoma care product.

What is Gelonet?

Gelonet is a paraffin gauze dressing (also known as paraffin tulle gras) that consists of open-weave cotton or viscose gauze impregnated with soft paraffin. While not specifically designed for stoma care, it has the following properties:

• Creates a non-adherent barrier between the wound and secondary dressing
• Helps prevent dressings from sticking to wounds
• Provides a moist environment for wound healing
• Allows drainage to pass through to secondary absorbent layers

Potential Applications in Stoma Care

While not mentioned in the stoma care guidelines 1, Gelonet could potentially be used in specific stoma-related situations:

1. For peristomal skin damage: When severe skin breakdown occurs, Gelonet might be used as a temporary measure to protect damaged skin while allowing drainage to pass through.

2. For entero-atmospheric fistulas: In cases of grade 3 open abdomen wounds with fistulas, paraffin gauze might be used as part of a management strategy, though negative pressure wound therapy (NPWT) is more commonly recommended 1.

3. As a protective layer: In cases where standard stoma accessories are not available or not tolerated, Gelonet could potentially serve as a temporary protective layer.

Standard Peristomal Skin Care Products

Current guidelines and research emphasize the use of specialized stoma care products rather than general wound dressings like Gelonet. The recommended products include:

• Barrier creams and films: To protect intact skin from effluent 2, 3
• Hydrocolloid flanges: Standard in modern stoma appliances, more skin-friendly than older acrylic adhesives 4
• Powders: For managing moist, denuded skin
• Pastes and seals: To fill creases and prevent leakage 2
• Convex appliances: For retracted stomas or to improve fit 2

Potential Concerns with Using Gelonet in Stoma Care

1. Adherence issues: Paraffin gauze may interfere with the adhesion of stoma appliances, potentially leading to leakage.

2. Skin reactions: Some patients may develop contact dermatitis to components in skin care products 5. Testing should be conducted if dermatitis occurs.

3. Limited evidence: There is insufficient evidence supporting the use of Gelonet specifically for stoma care. A systematic review of randomized controlled trials for peristomal skin care did not identify Gelonet as a studied intervention 6.

Best Practices for Peristomal Skin Care

Instead of using general wound dressings like Gelonet, current guidelines recommend:

1. Prevention of skin damage: Ensuring proper fitting of stoma appliances to prevent leakage 1

2. Regular assessment: Monitoring the peristomal skin for signs of irritation, breakdown, or allergic reactions 3

3. Specialized products: Using purpose-designed stoma accessories for specific problems:

   • Barrier rings for uneven surfaces
   • Convex appliances for flush or retracted stomas
   • Stoma powder for weeping skin
   • Barrier films for protection 1, 2

4. Management of complications: Prompt identification and treatment of specific peristomal skin conditions using appropriate products 3

Conclusion

While Gelonet is not specifically recommended in stoma care guidelines, understanding the full range of wound care products available can help in managing complex cases. For routine stoma care, specialized ostomy products designed specifically for peristomal skin protection should be prioritized over general wound dressings like Gelonet.