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Ducey J, Kennedy AM, Linsell L, Woolfall K, Hall NJ, Gale C, Battersby C, Penman G, Knight M, Lansdale N. Timing of neonatal stoma closure: a survey of health professional perspectives and current practice. Arch Dis Child Fetal Neonatal Ed 2022; 107:448-450. [PMID: 34413091 PMCID: PMC9209674 DOI: 10.1136/archdischild-2021-322040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/09/2021] [Indexed: 12/03/2022]
Abstract
Optimal timing for neonatal stoma closure remains unclear. In this study, we aimed to establish current practice and illustrate multidisciplinary perspectives on timing of stoma closure using an online survey sent to all 27 UK neonatal surgical units, as part of a research programme to determine the feasibility of a clinical trial comparing 'early' and 'late' stoma closure. 166 responses from all 27 units demonstrated concordance of opinion in target time for closure (6 weeks most commonly stated across scenarios), although there was a high variability in practice. A sizeable proportion (41%) of respondents use weight, rather than time, to determine when to close a neonatal stoma. Thematic analysis of free text responses identified nine key themes influencing decision-making; most related to nutrition, growth and stoma complications. These data provide an overview of current practice that is critical to informing an acceptable trial design.
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Affiliation(s)
- Jonathan Ducey
- Department of Paediatric and Neonatal Surgery, Royal Manchester Children's Hospital, Manchester, UK
| | - Ann M Kennedy
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Louise Linsell
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kerry Woolfall
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Nigel J Hall
- University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Chris Gale
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Cheryl Battersby
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Gareth Penman
- Newborn Intensive Care Unit, St Mary’s Hospital, Manchester, UK
| | - Marian Knight
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nick Lansdale
- Department of Paediatric and Neonatal Surgery, Royal Manchester Children's Hospital, Manchester, UK .,Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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