Coloplast Ostomy Skin Tool

1
Coloplast Ostomy Skin Tool
2
This is a standardised way to

• Score the peristomal skin through objective
  observations
• Categorise the peristomal skin disorders
  according to their cause

3
What is the tool meant to do?

• This tool is designed to assess peristomal skin
• The tool is designed to assess the state of the
  peristomal skin at that particular point in time
• Assess if there has been an improvement or a
  degradation over time
• Reduce the amount of time nurses spend on
  evaluating a disorder

• It is not meant to to predict deterioration of a
  current condition or predict the occurrence of an
  abnormal skin condition
• It is not meant to assess the extent of care
  needed

• The tool was developed in association with the
  Coloplast Global Advisory Board

4
A closer look at scoring

• Examine the peristomal skin and evaluate the skin
  based on the descriptions in three domains
• Discolouration
• Erosion
• Tissue overgrowth
• Maximum points in each domain
• Size of affected area 3 points
• Severity 2 points
• Highest possible score 15

5
Assessing the affected area and severity

• Then assess the severity score
• Severity should only be assessed when there is an
  area score from 13
• Assess the severity according to the descriptions
  within the three domains

First assess the area that is affected
6
Step 1 DET score
7
Step 2 The diagnostic guide
8
Scoring a skin disorder
9
Normal skin

• Discolouration
• There is no area of discolouration, therefore,
  the score is 0
• As there is no discolouration, the severity must
  also 0As there is no discolouration observed
  the score will also be 0 in the rest of the
  domains as follows
• Erosion
• There is no evidence of erosion, therefore, the
  score is 0
• As there is no erosion, the severity must also be
  0
• Tissue overgrowth
• There is no tissue overgrowth, therefore, the
  score is 0
• As there is no tissue overgrowth, the severity
  must also be 0

Total score 0
10
Domain 1 Area of discolouration
The area of discolouration is 2550 of the total
adhesion area
Therefore, the area score 2
2
11
Domain 1 Severity of discolouration
The area is severely discoloured
Therefore, the severity 2
2
12
Domain 2 Area of erosion
The area of erosion is 2550 of the total
adhesion area
Therefore, the area score 2
2
13
Domain 2 Severity of erosion
The area is not severely eroded
Therefore, the severity 1
1
14
Domain 3 Area of tissue overgrowth
The area of tissue overgrowth is less than 25 of
the total adhesion area
Therefore, the area score 1
1
15
Domain 3 Severity of tissue overgrowth
The area is not severely overgrown
Therefore the severity 1
1
16
Summary Patient score

• Domain 1 2 2 4
• Area of discolouration 2
• Severity of discolouration 2
• Domain 2 2 1 3
• Area of erosion 2
• Severity of erosion 1
• Domain 3 1 1 2
• Area of tissue overgrowth 1
• Severity of tissue overgrowth 1

17
The diagnostic guide
18
How to use the diagnostic guide
19
Observations

• Discolouration
• Loss of
• epidermis
• Hyperplasia

20
The patient consultation
21
Diagnostic category
22
Please remember

• Both DET score and diagnostic guide must be used
  every time you assess a patient
• When scoring the peristomal skin you must go
  through the 3 domains every time

23
How to use our Grid

• Place the grid covering the stoma peristomal
  skin area
• The stoma should be in the center

24
Draw the adhesive area on the grid
25
Draw the stoma on the grid

• And cut out the area

26
Draw the area of skin disorder
27
Calculate area of skin disorder
By counting area of adhesive and area of skin
disorder