Editorial
Copyright ©2006 Baishideng Publishing Group Co.
World J Gastroenterol. May 28, 2006; 12(20): 3133-3137
Published online May 28, 2006. doi: 10.3748/wjg.v12.i20.3133
Table 1 Medical management of parostomal ulcers
AuthorDesignNumber of patientsTreatmentSummary
Wolfson et alRetrospective Review10 patients (8 with IBD), 5 with PPGPatients with PPG received systemic steroids or IBD therapy. Other patients were treated with conservative measures, corticosteroid creams, wound care.Patients with IBD should be treated systemically. Patients with other causes for ulceration should be evaluated by dermatology and receive local therapy.
Last et alRetrospective Review17 patients with Crohn's who developed 28 ulcersTreatment included debridement, curettage, unroofing the ulcer complex, pouching of the stoma with Telfa strips in the ulcer base.6 patients did not respond to conservative management, and required relocation.
Hughes et alRetrospective Review7 patientsTopical clobetasol propionate used with intralesional injection of triamcinolone acetonide in seven patients. Three patients received an immunosuppressive agent (cyclosporine or mycophenolate). Oral dapsone was used in patients.The underlying disease process must be treated along with local wound care management (i.e. the addition of a topical corticosteroid).
Hayashi et alRetrospective Review15 children with stomal or perineal skin ulcerationUsed topical sucralfate after failure of other common first line agents.Topical sucralfate can be soothing when other measures fail.