Background: Peristomal skin disorders are one of the most frequent complications on the abdominal stoma. Currently therapeutic approaches do not take into account the specific characteristics of this type of wound.   Objectives: To assess in a first series of patients not responding to treatment with traditional dressings, the effectiveness of a topic wound dressing with Neem Oil and Red Hypericum Oil, applied so as to guarantee the adhesiveness of the pouching system. This product, currently indicated to treat wounds of all aetiologies, acts as antimicrobial, bacteriostatic and mechanical barrier and promotes natural tissue repair.  Methods: The two patients we enrolled presented peristomal wounds not responding to treatment with traditional dressings. To comply with the need of applying adhesive pouching we had to devise a suitable wound dressing. The patients were treated twice weekly, by applying the product on an hydrofiber dressing support, protected by a transparent film. No local antiseptics were used.  Results:  Complete healing of the lesions, in the first case after 14 days, in the second after 28 days, with immediate pain decrease. Both patients showed a positive attitude towards the treatment. The dressing design allowed the appliance to remain in place for three days with no complications. Conclusions: The use of the Neem Oil and Red Hypericum Oil dressing can be a valid therapeutic solution in the treatment of difficult to heal peristomal wounds, and therefore deserves to be confirmed through studies involving a higher number of patients.

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