What is the rationale for using a solid skin barrier around the ileostomy?

• A. To absorb drainage
• B. To protect skin from enzymes in drainage
• C. To reduce odor
• D. To accelerate healing

Answer: (B)

Protecting peristomal skin from caustic drainage enzymes is the reason for using a solid skin barrier around an ileostomy. The ileostomy output is rich in digestive enzymes and bile acids that can irritate or erode the skin with direct contact. A solid barrier sits against the skin and around the stoma, forming a protective layer that shields the skin from those enzymes and helps create a snug seal to prevent leakage. By keeping the skin intact, it reduces irritation and dermatitis and supports a stable, comfortable appliance fit. It’s not primarily about absorbing drainage, masking odor, or speeding healing, though preserving skin integrity can indirectly aid healing by preventing ongoing skin damage.