UNAIR NEWS – Nature has provided everything. Coconut (Cocos nucifera) is even more useful than what we think. A specialist of digestive surgery division, Dr. Vicky S Budipramana, dr., Spb., KBwD, found a good use of coconut shell, as a skin barrier (liquid container) for colostomy cancer patients. The skin barrier from the coconut shell is safe, inexpensive, and has more advantages compared to the product manufacturer.
Vicky explained, colostomy cancer treatment always comes down to an operation removing the cancer, from the intestine to the surrounding tissue. After surgical removal of the cancer, remaining colon in it cannot be directly connected. The solution, a part of the intestines is removed from the stomach temporarily for the recovery process.
“So, during the recovery, excreta discharge process takes place outside the abdomen. This condition causes new problems. In cases we often encountered, patients often experienced severe inflammation in the surface of the skin around their stomach, “said the researcher of Department of Surgery, Faculty of Medicine, Universitas Airlangga / Dr. Soetomo General Hospital.
It happens because they do not use proper excreta liquid container. As a result, every time it is discharged out of the intestines, the liquid cannot be properly contained. As we all know, excreta liquid is alkaline, while the skin surface is alkaline in nature. Skin which makes contact with excreta liquid will damage the skin protector and inflammation happens.
“We often perform an operation from the part of the small intestine because it is easier to do. In addition, the liquid that excreted is still a watery and odorless, unlike the waste products from the large intestine. However, there is a risk that it leaks and spills on the skin surface, if the container is not good, “he explained.
These issues were then inspired him to find a solution. Moreover, most patients are those who came from the countryside. “The majority of patients came in poor condition. They were in pain because of the skin blisters and inflammation. In fact, there were patients died because of the pain. Not because of his illness, but because they cannot withstand the pain of sepsis, “he explained.
To heal, the skin should remain dry. After they are recovered, intestinal surgery grafting can be done. However, as long as the skin condition has not improved, intestinal surgery cannot be done.
To get the perfect skin barrier, the form of coconut shell is adjusted so that the convex surface of the shell can be applied to the skin peristoma and end (stump) protruding intestine (protrusion) through shell holes located in the central part. Coconut shell natural shape is concave so it is appropriate with the skin barrier. In addition, the absorption rate is also high.
“To make the intestinal stump possible for protrusion, pressure should be applied through circular belt at the waist, so the excreta coming out without making contact with peristoma of the skin,” he said.
Firmness of the belt can be adjusted individually to meet patient’s comfort. It is like wearing a belt. Porous coconut shell can act as an adsorbent Excreta and liquid perspiration on the skin surface will be absorbed by the convex surface of coconut shell, so that the skin is free from exposure to excreta. Patients can wear a stoma bag coconut shell to overcome the problem of skin damage.
“Economically, the use of stoma bag with coconut shell skin barrier can ease the burden on patients because the coconut shell is very cheap, can be made, and can be used repeatedly,” he explained.
He claimed that the coconut shell skin barrier has a high absorption rate. The more frequent it is used, the higher the absorption rate. The frequent use caused the pores of the shell widening.
“Intestinal germs have cellulase enzymes, while the shell is cellulose. Cellulose in coconut shell will be eaten by the enzyme cellulase so the shell pores widened even more. This makes the shell has a higher absorption rate. But don’t let it covered by crust. It must be cleaned to prevent crust. Because the crust will interfere with the absorption process, “he explained.
Coconut shells used must be old coconut shells because they have already had the ability to absorb. Unlike the young shell which contains a lot of water making it difficult to absorb the water. (*)
Author: Sefya H. Istighfarica
Editor: Defrina Sukma S