In treating mechanical trauma to peristomal skin, what is the initial step?

• A. Identify the cause
• B. Prevent recurrence
• C. Treat the skin
• D. Re-evaluate the appliance fit

Answer: (A)

Identifying the cause is the first move because mechanical trauma stems from a specific trigger, such as an ill-fitting appliance, leakage, friction, or irritants in the effluent. By pinpointing what is actually aggravating the skin, you can target the remedy—adjusting the appliance fit, changing barrier materials, or addressing moisture and friction—so the problem doesn’t recur. Only after the underlying cause is addressed do you treat any existing skin damage and protect it moving forward. If you jump straight to treating the skin without clarifying the cause, the trauma is likely to come back.