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Ayik C, Bişgin T, Cenan D, Manoğlu B, Özden D, Sökmen S. Risk factors for early ostomy complications in emergency and elective colorectal surgery: A single-center retrospective cohort study. Scand J Surg 2024; 113:50-59. [PMID: 38041524 DOI: 10.1177/14574969231190291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
BACKGROUND AND AIMS The clinical significance of early ostomy complications has been emphasized worldwide, and the current evidence concerning the impact of emergency or elective surgery on ostomy complications is limited. This study aimed to investigate the effect of elective and emergency colorectal surgery on early ostomy complications and the risk factors associated with specific complications. METHODS A mandatory colorectal recording system for consecutive ostomy patients between 2012 and 2020 was reviewed retrospectively. Patient socio-demographics, ostomy-related variables, and early period ostomy complications were retrieved from the patient records. The chi-square test, t-test, analysis of variance (ANOVA), and logistic regression were used to analyze the data. RESULTS The study cohort included 872 patients. At least one or more complications developed in 573 (65.7%) patients, 356 (63.6%) in the emergency group, and 217 (69.6%) in the elective group. When comparing emergency surgery to elective surgery, necrosis (7.4% versus 3.4%, p = 0.009), mucocutaneous separation (37.2% versus 27.1%, p = 0.002), and bleeding (6.1% versus 2.1%, p = 0.003) were more prevalent. Peristomal irritant contact dermatitis (PICD) (37.3% versus 26%, p < 0.001) was more common in elective surgery. Risk factors for PICD were comorbidity (p = 0.003), malignant disease (p = 0.047), and loop ostomy (p < 0.001) in elective surgery; female sex (p = 0.025), neo-adjuvant therapy (p = 0.024), and ileostomy (p = 0.006) in emergency surgery. The height of the ostomy (less than 10 mm) was a modifiable risk factor for mucocutaneous separation in both elective surgery (p < 0.001) and emergency surgery (p = 0.045). CONCLUSION Early ostomy complications were more likely to occur after emergency colorectal surgery than in an elective setting. Patient- and ostomy-related risk factors for complications differed between elective and emergency surgeries.
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Affiliation(s)
- Cahide Ayik
- Assistant Professor, Faculty of Nursing, Dokuz Eylul University, Izmir 35330, Turkey
| | - Tayfun Bişgin
- Department of General Surgery, Dokuz Eylul University, Turkey
| | - Deniz Cenan
- Dokuz Eylul University Hospital, Izmir, Turkey
| | - Berk Manoğlu
- Department of General Surgery, Dokuz Eylul University, Izmir, Turkey
| | - Dilek Özden
- Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Selman Sökmen
- Department of General Surgery, Dokuz Eylul University, Izmir, Turkey
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Wei‐ying Z, Hui‐ren Z, Hai‐ping Y, Li‐li M. The effect of telemedicine on stoma-related complications in adults with enterostomy: A systematic review and meta-analysis. Int Wound J 2024; 21:e14572. [PMID: 38272790 PMCID: PMC10789586 DOI: 10.1111/iwj.14572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/04/2023] [Indexed: 01/27/2024] Open
Abstract
To assess the effect of telemedicine on stoma-related complications in adults with enterostomy, we conducted a meta-analysis to evaluate the effects of the telemedicine group compared to the usual group. Literature searches were performed in PubMed, Embase, Web of Science, The Cochrane Library, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), WanFang and VIP databases from their inception up to October 2023. Two authors independently screened and extracted data from the included and excluded literature according to predetermined criteria. Data collected were subjected to meta-analysis using Review Manager 5.3 software. The final analysis included a total of 22 articles, encompassing 2237 patients (telemedicine group: 1125 patients, usual group: 1112 patients). The meta-analysis results demonstrated that, compared to the usual group, the telemedicine group significantly reduced the overall occurrence of stoma-related complications, with an odds ratio (OR) of 0.22 (95% CI = 0.15-0.32, p < 0.00001). Furthermore, it resulted in a decrease in stoma complications (OR = 0.27, 95% CI = 0.15-0.47, p < 0.00001) and peristomal complications (OR = 0.25, 95% CI = 0.19-0.34, p < 0.00001). Therefore, the existing evidence suggests that the application of telemedicine can reduce the incidence of stoma and peristomal complications, making it a valuable clinical recommendation.
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Affiliation(s)
- Zhang Wei‐ying
- Shanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Zhuang Hui‐ren
- Shanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Yu Hai‐ping
- Shanghai East HospitalTongji University School of MedicineShanghaiChina
| | - Ma Li‐li
- Shanghai East HospitalTongji University School of MedicineShanghaiChina
- East Hosptial Affiliated toTongji UniversityShanghaiChina
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3
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Doucette JE, Mawn BE, Beitz JM, Koren A. Factors Affecting Psychosocial Adjustment in Persons With a Recent Ostomy. J Wound Ostomy Continence Nurs 2023; 50:297-306. [PMID: 37467408 DOI: 10.1097/won.0000000000000986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
PURPOSE The aim of this study was to examine the influence of personal and clinical factors on psychosocial adjustment in persons living with an ostomy for less than 1 year. DESIGN A cross-sectional survey. SUBJECTS AND SETTING The study sample comprised 183 adult individuals who had a colostomy, ileostomy, or urostomy for less than 1 year, residing in the Northeastern United States. METHODS Data were collected from May through November 2018 using 2 instruments: a sociodemographic questionnaire and the Ostomy Adjustment Inventory-23 (OAI-23). The OAI-23 items measured 4 psychosocial subscales: acceptance, anxious preoccupation, social engagement, and anger. Data were analyzed using analysis of variance, multivariate analysis of variance, Cramer's V correlations, and multiple regression. RESULTS Univariate analysis indicated that factors influencing psychosocial adjustment to an ostomy include age, assistance with care, educational background, stomal type, body mass index, ostomy height, preoperative education, and stoma siting. Multivariate analysis of variance identified that those who reported independence with ostomy care experienced higher levels of adjustment in all areas of the OAI-23. CONCLUSIONS Findings from this study may assist nurses and other care providers to better understand the physical and emotional needs of those with ostomies and to identify interventions to promote optimal health in this population.
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Affiliation(s)
- Jeffrey E Doucette
- Jeffrey E. Doucette, PhD, RN, CWOCN, Senior WOC Nurse, UMass Memorial Medical Center, Worcester, Massachusetts
- Barbara E. Mawn, PhD, RN, Solomont School of Nursing, University of Massachusetts Lowell
- Janice M. Beitz, PhD, RN, CS, CNOR, CWOCN-AP, CRNP, APNC, ANEF, FNAP, FAAN, Rutgers University School of Nursing-Camden, Camden, New Jersey
- Ainat Koren, PhD, DNP, PMHNP, Solomont School of Nursing, University of Massachusetts Lowell
| | - Barbara E Mawn
- Jeffrey E. Doucette, PhD, RN, CWOCN, Senior WOC Nurse, UMass Memorial Medical Center, Worcester, Massachusetts
- Barbara E. Mawn, PhD, RN, Solomont School of Nursing, University of Massachusetts Lowell
- Janice M. Beitz, PhD, RN, CS, CNOR, CWOCN-AP, CRNP, APNC, ANEF, FNAP, FAAN, Rutgers University School of Nursing-Camden, Camden, New Jersey
- Ainat Koren, PhD, DNP, PMHNP, Solomont School of Nursing, University of Massachusetts Lowell
| | - Janice M Beitz
- Jeffrey E. Doucette, PhD, RN, CWOCN, Senior WOC Nurse, UMass Memorial Medical Center, Worcester, Massachusetts
- Barbara E. Mawn, PhD, RN, Solomont School of Nursing, University of Massachusetts Lowell
- Janice M. Beitz, PhD, RN, CS, CNOR, CWOCN-AP, CRNP, APNC, ANEF, FNAP, FAAN, Rutgers University School of Nursing-Camden, Camden, New Jersey
- Ainat Koren, PhD, DNP, PMHNP, Solomont School of Nursing, University of Massachusetts Lowell
| | - Ainat Koren
- Jeffrey E. Doucette, PhD, RN, CWOCN, Senior WOC Nurse, UMass Memorial Medical Center, Worcester, Massachusetts
- Barbara E. Mawn, PhD, RN, Solomont School of Nursing, University of Massachusetts Lowell
- Janice M. Beitz, PhD, RN, CS, CNOR, CWOCN-AP, CRNP, APNC, ANEF, FNAP, FAAN, Rutgers University School of Nursing-Camden, Camden, New Jersey
- Ainat Koren, PhD, DNP, PMHNP, Solomont School of Nursing, University of Massachusetts Lowell
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Indrebø KL, Aasprang A, Olsen TE, Andersen JR. Factors associated with leakage in patients with an ostomy: A cross-sectional study. Nurs Open 2023; 10:3635-3645. [PMID: 36691880 PMCID: PMC10170928 DOI: 10.1002/nop2.1612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 11/01/2022] [Accepted: 12/16/2022] [Indexed: 01/25/2023] Open
Abstract
AIMS To explore the associations between sociodemographic and clinical data, the patient's knowledge and skills, and relationship to healthcare professionals with leakage from an ostomy. DESIGN Cross-sectional. METHODS This study included 160 patients with a colostomy, ileostomy, or urostomy. Leakage was the dependent variable and was assessed by self-report. Sociodemographic and clinical data and the Ostomy Adjustment Scale subscores, 'knowledge and skills' and 'health care professionals' were independent variables. Spearman's rho and multivariate partial least squares regression analysis were used to estimate possible factors associated with leakage. RESULTS Of the participants, 13.8% had leakage weekly or more often, 16.3% more often than once a month and 37, 5% had leakage more seldom than once a month. The most important risk factors for leakage were (1) having an ostomy placement that does not meet international guidelines, (2) not having an optimal relationship with health professionals, (3) having a diagnosis other than cancer, (4) not having proper knowledge and skills in ostomy care, (5) not having a colostomy, (6) having a convex baseplate, (7) having an oval ostomy, and (8) being dependent on others for ostomy care. The independent variables in the PLS- model explained 31% of the variance in leakage. PATIENT OR PUBLIC CONTRIBUTION We thank the patients in the user panel for their help during the study.
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Affiliation(s)
- Kirsten Lerum Indrebø
- Department of Surgery, Førde Central Hospital, Førde, Norway.,Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway
| | - Anny Aasprang
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway.,Centre of Health Research, Førde Hospital Trust, Førde, Norway
| | - Torill Elin Olsen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Surgery, Haukeland University Hospital, Bergen, Norway
| | - John Roger Andersen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Førde, Norway.,Centre of Health Research, Førde Hospital Trust, Førde, Norway
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Abstract
OBJECTIVE To establish a consensus on terminology used to define stomal, parastomal, and peristomal complications in Australia. METHODS A list of stomal, parastomal, and peristomal complications was generated through group dialogue, which was informed by clinical and academic knowledge of the researchers. An extensive literature review was undertaken to identify any additional terms and to create a database of definitions/descriptions. A library of images related to the identified conditions was generated. An online Delphi process was conducted among a representative, purposive sample of Australia expert wound, ostomy, and continence nurses and colorectal surgeons. Ten terms were presented to the panel with descriptive photographs of each complication. Up to three Delphi rounds and, if necessary, a priority voting round were conducted. RESULTS Seven of the 10 terms reached agreement in the first round. One term ( allergic dermatitis ) was refined ( allergic contact dermatitis ) and reached agreement in the second round. Two terms ( mucocutaneous granuloma and mucosal granuloma ) were considered by the panel to be the same condition in different anatomical locations and were combined as one term ( granuloma ). Two terms ( skin stripping and tension blisters ) were combined as one term ( medical adhesive-related skin injury ) and reached agreement in round 2. CONCLUSIONS A consensus in terminology used to describe stomal or parastomal/peristomal complications will enhance communication among patients and health professionals and advance opportunities for education and benchmarking of stomal, parastomal, and peristomal complications nationally.
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Colwell JC, Stoia Davis J, Emodi K, Fellows J, Mahoney M, McDade B, Porten S, Raskin E, Sims T, Norman H, Kelly MT, Gray M. Use of a Convex Pouching System in the Postoperative Period: A National Consensus. J Wound Ostomy Continence Nurs 2022; 49:240-246. [PMID: 35523239 PMCID: PMC9093727 DOI: 10.1097/won.0000000000000874] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Convex pouching systems have been available for ostomy patients for decades; however, controversy remains over the use of convexity in the postoperative period. A group of 10 nurses and physicians with expertise caring for patients with an ostomy completed a scoping review identifying research-based evidence and gaps in our knowledge of the safety and effectiveness related to the use of a convex pouching system following ostomy surgery. Results of this scoping review demonstrated the need for a structured consensus to define best practices when selecting a pouching system that provides a secure and reliable seal around the stoma, avoids undermining and leakage of effluent from the pouching system, and contributes to optimal health-related quality of life for patients following ostomy surgery. The expert panel reached consensus on 8 statements for the use of convex products immediately after surgery and throughout the first 6 months after stoma creation, as well as describing goals in choosing the best pouching system for the patient with an ostomy.
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Affiliation(s)
- Janice C. Colwell
- Correspondence: Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, 1335 S. Prairie Ave, Chicago, IL 60605 ()
| | - Janet Stoia Davis
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Krisztina Emodi
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Jane Fellows
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Mary Mahoney
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Bethany McDade
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Sima Porten
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Elizabeth Raskin
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Terran Sims
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Holly Norman
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Matthew T. Kelly
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
| | - Mikel Gray
- Janice C. Colwell, MS, APRN, CWOCN, FAAN, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
- Janet Stoia Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco
- Jane Fellows, MSN, RN-CNS, COCN-AP, Duke University, Durham, North Carolina
- Mary Mahoney, MSN, RN, CWOCN, CFCN, UnityPoint at Home, Urbandale, Iowa
- Bethany McDade, MS, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima Porten, MD, University of California San Francisco
- Elizabeth Raskin, MD, University of California, Davis
- Terran Sims, MSN, ACNP-C, University of Virginia, Charlottesville
- Holly Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Department of Urology, University of Virginia, Charlottesville
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Maglio A, Malvone AP, Scaduto V, Brambilla D, Denti FC. The frequency of early stomal, peristomal and skin complications. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2021; 30:1272-1276. [PMID: 34889670 DOI: 10.12968/bjon.2021.30.22.1272] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The incidence of early complications after stoma formation (within 30 days of surgery) is difficult to determine and has been reported to be in a range of 3%-82%. AIM The aim of this study was to analyse the onset of stomal, peristomal and skin complications one month (30 days) after ostomy creation. METHOD This review analysed enteral stoma therapy nurse reports on patients who had an ostomy created between January 2016 and December 2020. FINDINGS Complications were analysed according to ostomy type: colostomy, ileostomy and urostomy. There were 1292 incidences of complications: skin complications were the most common (26%), and abscess the least common (0%). CONCLUSION A majority (63%) of patients experienced at least one or more complications within 30 days of surgery. Haemorrhage was reported as a complication (2%) but the authors found no data on its incidence in the literature. In addition to early complications, late complications were detected.
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Affiliation(s)
- Andrea Maglio
- Enteral Stoma Nurse, General and Emergency Surgery, and Gastroenterological Surgery Departments, San Raffaele Hospital, Milan, Italy
| | - Alessandro Pasquale Malvone
- Nurse, General and Emergency Surgery, and Gastroenterological Surgery Departments, San Raffaele Hospital, Milan, Italy
| | - Vitalba Scaduto
- Nurse, General and Emergency Surgery, and Gastroenterological Surgery Departments, San Raffaele Hospital, Milan, Italy
| | - Davide Brambilla
- Multi-specialist Ambulatory Nurse, San Raffaele Hospital, Milan, Italy
| | - Francesco Carlo Denti
- Enteral Stoma Nurse, General and Emergency Surgery, and Gastroenterological Surgery Departments, San Raffaele Hospital, Milan, Italy
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Correa Marinez A, Bock D, Carlsson E, Petersén C, Erestam S, Kälebo P, Rosenberg J, Haglind E, Angenete E. Stoma-related complications: a report from the Stoma-Const randomized controlled trial. Colorectal Dis 2021; 23:1091-1101. [PMID: 33326678 DOI: 10.1111/codi.15494] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 12/07/2022]
Abstract
AIM The impact of construction techniques on the development of stoma complications is partly undiscovered. The aim of this paper was to report and analyse the impact of the three surgical techniques in a randomized controlled trial Stoma-Const on stoma-related complications as well as identifying risk factors and patient-reported stoma function as a planned secondary analysis. METHODS This was a randomized, multicenter trial where all patients scheduled to receive an end colostomy were invited to participate. Patients were randomized to one of three techniques for stoma construction; cruciate fascial incision, circular incision or prophylactic mesh. Stoma complications were assessed by a surgeon and stoma care nurses within 1 year postoperatively. RESULTS Two hundred and nine patients were randomized. Patient demographics were similar in all three groups. Data on stoma-related complications were available for analysis in 201 patients. A total of 127 patients (63%) developed some type of stoma complication within 1 year after surgery. The risk ratio (95% CI) for stoma complications was 0.93 (0.73; 1.2) between cruciate vs. circular incision groups and 1.02 (0.78; 1.34) between cruciate vs. mesh groups. There were no statistically significant differences between the groups regarding parastomal hernia rate and no risk factors could be identified. CONCLUSION This randomized trial confirmed a high prevalence of stoma-related complications but could not identify an impact of surgical technique or identify modifiable risk factors for stoma-related complications.
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Affiliation(s)
- Adiela Correa Marinez
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Scandinavian Surgical Outcomes Research Group, University of Gothenburg, Gothenburg, Sweden.,Department of Surgery, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - David Bock
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Scandinavian Surgical Outcomes Research Group, University of Gothenburg, Gothenburg, Sweden
| | - Eva Carlsson
- Department of Surgery, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Charlotta Petersén
- Department of Surgery, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Sofia Erestam
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Scandinavian Surgical Outcomes Research Group, University of Gothenburg, Gothenburg, Sweden
| | - Peter Kälebo
- Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jacob Rosenberg
- Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Eva Haglind
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Scandinavian Surgical Outcomes Research Group, University of Gothenburg, Gothenburg, Sweden.,Department of Surgery, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Eva Angenete
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Scandinavian Surgical Outcomes Research Group, University of Gothenburg, Gothenburg, Sweden.,Department of Surgery, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
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9
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Roveron G, Barbierato M, Rizzo G, Parini D, Bondurri A, Veltri M, Pata F, Cattaneo F, Tafuri A, Forni C, Ferrara F. Italian Guidelines for the Nursing Management of Enteral and Urinary Stomas in Adults: An Executive Summary. J Wound Ostomy Continence Nurs 2021; 48:137-147. [PMID: 33690248 DOI: 10.1097/won.0000000000000745] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This article is an executive summary of Italian guidelines for nursing management of enteral and urinary ostomies in adults. METHODS Scoping review and generation of evidence and consensus-based clinical guidelines. SEARCH STRATEGY The Multidisciplinary Italian Study group for STOmas (MISSTO) was founded in 2018. This group created guidelines for management of enteral and urinary ostomies in adults based on a scoping review of the literature. The research included previous guidelines, systematic reviews, meta-analyses, randomized clinical trials, cohort studies, and case reports. Five main topics were identified: "stoma preparation," "stoma creation," "stoma complications," "stoma care," and "stoma reversal" (for enteral stomas)." All the studies were evaluated according to the GRADE system and AGREE II tool. Recommendations were elaborated in the form of statements, with an established grade of recommendation for each statement. For low levels of scientific evidence statements, a consensus conference composed of expert members of the major Italian scientific societies in the field of stoma management and care discussed, corrected, validated, or eliminated the statements. A final version of the guidelines with definitive recommendations was elaborated and prepared for publication. FINDINGS/CONCLUSIONS This document represents the first Italian guidelines on enteral and urinary stoma management to assist nurses caring for persons with an enteral or urinary ostomy.
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Affiliation(s)
- Gabriele Roveron
- Gabriele Roveron, RN, Ostomy and Pelvic Floor Rehabilitation Centre, S. Maria Della Misericordia Hospital, Rovigo, Italy
- Maria Barbierato, RN, Ostomy Centre, Azienda Ospedaliera di Padova, Padova, Italy
- Gianluca Rizzo, MD, Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dario Parini, MD, General Surgery Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
- Andrea Bondurri, MD , Department of General Surgery, Luigi Sacco University Hospital, ASST FBF-Sacco, Milan, Italy
- Marco Veltri, MD, General Surgery Unit, San Jacopo Hospital, Pistoia, Italy
- Francesco Pata, MD, General Surgery Unit, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
- Francesco Cattaneo, MD, Department of Oncological and Surgical Sciences, Urology Clinic, University of Padova, Italy
- Alessandro Tafuri, MD , Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona Italy
- Cristiana Forni, RN , Nursing and Allied Profession Research Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Francesco Ferrara, MD, Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Maria Barbierato
- Gabriele Roveron, RN, Ostomy and Pelvic Floor Rehabilitation Centre, S. Maria Della Misericordia Hospital, Rovigo, Italy
- Maria Barbierato, RN, Ostomy Centre, Azienda Ospedaliera di Padova, Padova, Italy
- Gianluca Rizzo, MD, Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dario Parini, MD, General Surgery Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
- Andrea Bondurri, MD , Department of General Surgery, Luigi Sacco University Hospital, ASST FBF-Sacco, Milan, Italy
- Marco Veltri, MD, General Surgery Unit, San Jacopo Hospital, Pistoia, Italy
- Francesco Pata, MD, General Surgery Unit, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
- Francesco Cattaneo, MD, Department of Oncological and Surgical Sciences, Urology Clinic, University of Padova, Italy
- Alessandro Tafuri, MD , Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona Italy
- Cristiana Forni, RN , Nursing and Allied Profession Research Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Francesco Ferrara, MD, Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Gianluca Rizzo
- Gabriele Roveron, RN, Ostomy and Pelvic Floor Rehabilitation Centre, S. Maria Della Misericordia Hospital, Rovigo, Italy
- Maria Barbierato, RN, Ostomy Centre, Azienda Ospedaliera di Padova, Padova, Italy
- Gianluca Rizzo, MD, Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dario Parini, MD, General Surgery Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
- Andrea Bondurri, MD , Department of General Surgery, Luigi Sacco University Hospital, ASST FBF-Sacco, Milan, Italy
- Marco Veltri, MD, General Surgery Unit, San Jacopo Hospital, Pistoia, Italy
- Francesco Pata, MD, General Surgery Unit, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
- Francesco Cattaneo, MD, Department of Oncological and Surgical Sciences, Urology Clinic, University of Padova, Italy
- Alessandro Tafuri, MD , Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona Italy
- Cristiana Forni, RN , Nursing and Allied Profession Research Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Francesco Ferrara, MD, Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Dario Parini
- Gabriele Roveron, RN, Ostomy and Pelvic Floor Rehabilitation Centre, S. Maria Della Misericordia Hospital, Rovigo, Italy
- Maria Barbierato, RN, Ostomy Centre, Azienda Ospedaliera di Padova, Padova, Italy
- Gianluca Rizzo, MD, Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dario Parini, MD, General Surgery Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
- Andrea Bondurri, MD , Department of General Surgery, Luigi Sacco University Hospital, ASST FBF-Sacco, Milan, Italy
- Marco Veltri, MD, General Surgery Unit, San Jacopo Hospital, Pistoia, Italy
- Francesco Pata, MD, General Surgery Unit, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
- Francesco Cattaneo, MD, Department of Oncological and Surgical Sciences, Urology Clinic, University of Padova, Italy
- Alessandro Tafuri, MD , Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona Italy
- Cristiana Forni, RN , Nursing and Allied Profession Research Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Francesco Ferrara, MD, Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Andrea Bondurri
- Gabriele Roveron, RN, Ostomy and Pelvic Floor Rehabilitation Centre, S. Maria Della Misericordia Hospital, Rovigo, Italy
- Maria Barbierato, RN, Ostomy Centre, Azienda Ospedaliera di Padova, Padova, Italy
- Gianluca Rizzo, MD, Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dario Parini, MD, General Surgery Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
- Andrea Bondurri, MD , Department of General Surgery, Luigi Sacco University Hospital, ASST FBF-Sacco, Milan, Italy
- Marco Veltri, MD, General Surgery Unit, San Jacopo Hospital, Pistoia, Italy
- Francesco Pata, MD, General Surgery Unit, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
- Francesco Cattaneo, MD, Department of Oncological and Surgical Sciences, Urology Clinic, University of Padova, Italy
- Alessandro Tafuri, MD , Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona Italy
- Cristiana Forni, RN , Nursing and Allied Profession Research Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Francesco Ferrara, MD, Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Marco Veltri
- Gabriele Roveron, RN, Ostomy and Pelvic Floor Rehabilitation Centre, S. Maria Della Misericordia Hospital, Rovigo, Italy
- Maria Barbierato, RN, Ostomy Centre, Azienda Ospedaliera di Padova, Padova, Italy
- Gianluca Rizzo, MD, Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dario Parini, MD, General Surgery Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
- Andrea Bondurri, MD , Department of General Surgery, Luigi Sacco University Hospital, ASST FBF-Sacco, Milan, Italy
- Marco Veltri, MD, General Surgery Unit, San Jacopo Hospital, Pistoia, Italy
- Francesco Pata, MD, General Surgery Unit, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
- Francesco Cattaneo, MD, Department of Oncological and Surgical Sciences, Urology Clinic, University of Padova, Italy
- Alessandro Tafuri, MD , Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona Italy
- Cristiana Forni, RN , Nursing and Allied Profession Research Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Francesco Ferrara, MD, Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Francesco Pata
- Gabriele Roveron, RN, Ostomy and Pelvic Floor Rehabilitation Centre, S. Maria Della Misericordia Hospital, Rovigo, Italy
- Maria Barbierato, RN, Ostomy Centre, Azienda Ospedaliera di Padova, Padova, Italy
- Gianluca Rizzo, MD, Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dario Parini, MD, General Surgery Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
- Andrea Bondurri, MD , Department of General Surgery, Luigi Sacco University Hospital, ASST FBF-Sacco, Milan, Italy
- Marco Veltri, MD, General Surgery Unit, San Jacopo Hospital, Pistoia, Italy
- Francesco Pata, MD, General Surgery Unit, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
- Francesco Cattaneo, MD, Department of Oncological and Surgical Sciences, Urology Clinic, University of Padova, Italy
- Alessandro Tafuri, MD , Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona Italy
- Cristiana Forni, RN , Nursing and Allied Profession Research Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Francesco Ferrara, MD, Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Francesco Cattaneo
- Gabriele Roveron, RN, Ostomy and Pelvic Floor Rehabilitation Centre, S. Maria Della Misericordia Hospital, Rovigo, Italy
- Maria Barbierato, RN, Ostomy Centre, Azienda Ospedaliera di Padova, Padova, Italy
- Gianluca Rizzo, MD, Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dario Parini, MD, General Surgery Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
- Andrea Bondurri, MD , Department of General Surgery, Luigi Sacco University Hospital, ASST FBF-Sacco, Milan, Italy
- Marco Veltri, MD, General Surgery Unit, San Jacopo Hospital, Pistoia, Italy
- Francesco Pata, MD, General Surgery Unit, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
- Francesco Cattaneo, MD, Department of Oncological and Surgical Sciences, Urology Clinic, University of Padova, Italy
- Alessandro Tafuri, MD , Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona Italy
- Cristiana Forni, RN , Nursing and Allied Profession Research Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Francesco Ferrara, MD, Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Alessandro Tafuri
- Gabriele Roveron, RN, Ostomy and Pelvic Floor Rehabilitation Centre, S. Maria Della Misericordia Hospital, Rovigo, Italy
- Maria Barbierato, RN, Ostomy Centre, Azienda Ospedaliera di Padova, Padova, Italy
- Gianluca Rizzo, MD, Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dario Parini, MD, General Surgery Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
- Andrea Bondurri, MD , Department of General Surgery, Luigi Sacco University Hospital, ASST FBF-Sacco, Milan, Italy
- Marco Veltri, MD, General Surgery Unit, San Jacopo Hospital, Pistoia, Italy
- Francesco Pata, MD, General Surgery Unit, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
- Francesco Cattaneo, MD, Department of Oncological and Surgical Sciences, Urology Clinic, University of Padova, Italy
- Alessandro Tafuri, MD , Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona Italy
- Cristiana Forni, RN , Nursing and Allied Profession Research Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Francesco Ferrara, MD, Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Cristiana Forni
- Gabriele Roveron, RN, Ostomy and Pelvic Floor Rehabilitation Centre, S. Maria Della Misericordia Hospital, Rovigo, Italy
- Maria Barbierato, RN, Ostomy Centre, Azienda Ospedaliera di Padova, Padova, Italy
- Gianluca Rizzo, MD, Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dario Parini, MD, General Surgery Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
- Andrea Bondurri, MD , Department of General Surgery, Luigi Sacco University Hospital, ASST FBF-Sacco, Milan, Italy
- Marco Veltri, MD, General Surgery Unit, San Jacopo Hospital, Pistoia, Italy
- Francesco Pata, MD, General Surgery Unit, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
- Francesco Cattaneo, MD, Department of Oncological and Surgical Sciences, Urology Clinic, University of Padova, Italy
- Alessandro Tafuri, MD , Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona Italy
- Cristiana Forni, RN , Nursing and Allied Profession Research Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Francesco Ferrara, MD, Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - Francesco Ferrara
- Gabriele Roveron, RN, Ostomy and Pelvic Floor Rehabilitation Centre, S. Maria Della Misericordia Hospital, Rovigo, Italy
- Maria Barbierato, RN, Ostomy Centre, Azienda Ospedaliera di Padova, Padova, Italy
- Gianluca Rizzo, MD, Department of Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dario Parini, MD, General Surgery Unit, Santa Maria Della Misericordia Hospital, Rovigo, Italy
- Andrea Bondurri, MD , Department of General Surgery, Luigi Sacco University Hospital, ASST FBF-Sacco, Milan, Italy
- Marco Veltri, MD, General Surgery Unit, San Jacopo Hospital, Pistoia, Italy
- Francesco Pata, MD, General Surgery Unit, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy
- Francesco Cattaneo, MD, Department of Oncological and Surgical Sciences, Urology Clinic, University of Padova, Italy
- Alessandro Tafuri, MD , Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona Italy
- Cristiana Forni, RN , Nursing and Allied Profession Research Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Francesco Ferrara, MD, Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
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Preoperative Stoma Site Marking Decreases Stoma and Peristomal Complications: A Meta-analysis. J Wound Ostomy Continence Nurs 2021; 47:249-256. [PMID: 32118803 DOI: 10.1097/won.0000000000000634] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
PURPOSE We systematically reviewed the literature in order to determine whether evidence indicated that preoperative stoma site marking reduces the occurrence of postoperative stoma and peristomal complications. DESIGN Systematic review with meta-analysis of pooled findings. SUBJECTS/SETTING We systematically reviewed 6 electronic databases including PubMed, MEDLINE, CINAHL, Cochrane Library for English language articles, along with the Airiti Library and Wanfang Data for Chinese articles for evidence related to the effects of stoma site marking on stoma and peristomal complications. We sought articles published from their inception to January 31, 2018. METHODS Ten studies that included 2109 participants, each comparing 2 groups of patients who did and did not undergo preoperative stoma site marking, were retrieved and analyzed. RESULTS In patients who underwent stoma site marking, the marking was associated with reduced stoma and peristomal complications in all stoma types (odds ratio [OR] = 0.52; 95% CI, 0.42-0.64; P < .001). Patients who underwent stoma and had fecal ostomies experienced fewer complications (OR = 0.34; 95% CI, 0.25-0.47; P < .001) than patients with unmarked stomas. In contrast, patients with urostomies did not experience fewer complications when compared to those with unmarked ostomies (OR = 0.531; 95% CI, 0.23-1.21; P = .132). Persons with fecal ostomies also had fewer hernias and peristomal skin complications (ORs = 0.25 and 0.30; 95% CIs, 0.09-0.71 and 0.20-0.44, respectively; both Ps < .001). The results revealed that stoma site marking was associated with reduced early and late stoma and peristomal complications (ORs = 0.76 and 0.38; 95% CIs, 0.61-0.94 and 0.32-0.46; P = .010 and P < .001, respectively). CONCLUSIONS Preoperative stoma site marking is associated with a reduced occurrence of stoma and peristomal complications and should be considered as a standard of preoperative care.
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WUWHS 2020 Global Healing Changing Lives, Abu Dhabi, UAE March 8-12. J Wound Care 2020; 29:1-314. [PMID: 32686975 DOI: 10.12968/jowc.2020.29.sup7b.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The abstract book contains the abstracts of keynote lectures, global gelebration, focus sessions, symposia, regional view, workshops, sponsored symposia, oral presentations, posters and the index.
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Menin G, Roveron G, Barbierato M, Peghetti A, Zanotti R. Design and validation of a "Peristomal Lesion Scale" for peristomal skin assessment. Int Wound J 2018; 16:433-441. [PMID: 30548924 DOI: 10.1111/iwj.13052] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/14/2018] [Accepted: 11/20/2018] [Indexed: 01/20/2023] Open
Abstract
Many people in Italy undergo ostomy because of illness, and this can have negative psychological and physical effects. It is estimated that 15%-43% of ostomates suffer from skin complications in the peristomal area. During their life, many ostomates experience at least one peristomal lesion, and they turn to stomal therapy centres where trained nurses provide patient care and manage skin complications. To ensure a good quality of life for patients, and to take prompt action for the prevention and treatment of stomal lesions, it is essential to use appropriate assessment tools. The aim of this study was to develop a reliable peristomal skin assessment tool (Peristomal Lesion Scale [PLS]) for classifying lesions based on their severity; and to compare its validity with the most widely used peristomal tool in Italy, SACS. The new tool was designed by a team of experts, focusing on patients' demographics, clinical characteristics, and classification of the lesions by severity and topography. The results of this comparative validation study indicate that the PLS better discriminates lesions by their severity because of its level of detail, using a standardised terminology, and its completeness. The PLS is a valid tool for use in the daily work of stomal therapists.
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Affiliation(s)
- Giulia Menin
- Immacolata Concezione Hospital, Piove di Sacco, Padova, Italy
| | | | | | | | - Renzo Zanotti
- Department of Molecular Medicine, University of Padova, Padova, Italy
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Nunes MLG, Santos VLCDG. Instrumentos de avaliação das complicações na pele periestoma: revisão integrativa. AQUICHAN 2018. [DOI: 10.5294/aqui.2018.18.4.9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Objetivo: identificar y analizar las herramientas utilizadas para evaluar las complicaciones de la piel periestoma a través de revisión integradora de la literatura. Materiales y método: la búsqueda se dio en estas bases y portales de datos: Biblioteca Virtual de la Salud (BVS), PubMed/MEDLINE, CINAHL, Scopus y Web of Science, de enero a febrero de 2018. Durante la búsqueda en las bases de datos, se utilizaron los descriptores: ostomía, colostomía, dermatitis y las palabras clave: instrumentos, complicaciones de la piel periestoma y evaluación de la piel periestoma. Se incluyeron estudios que cumplieron los siguientes criterios: que estén disponibles en su totalidad, que estén publicados en español, inglés y portugués, no se tuvo en cuenta el rango de tiempo y tenía que ser acerca de las herramientas de evaluación de las condiciones de la piel periestoma. Resultados: el análisis identificó la existencia de nueve instrumentos con diferentes parámetros para describir la piel periestoma. En general, los instrumentos describen los cambios basados en la clasificación de la complicación, en la causa del daño a la piel o en las características clínicas presentes. Los estudios evidenciaron, además, que la mayoría de los instrumentos no poseen propiedades de medida probadas. Conclusión: de los nueve instrumentos de evaluación identificados, solo cuatro tienen propiedades de medidas probadas. El enfermero debe conocer los instrumentos existentes confiables y válidos para describir y clasificar la gravedad de los problemas de la piel periestoma, lo que aporta a la sistematización de un diagnóstico más preciso y mejora, por lo tanto, la calidad del cuidado.
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Postoperative management of radical cystectomy. Review of the evidence on the prevention and treatment of urological complications. Actas Urol Esp 2018; 42:143-151. [PMID: 28587844 DOI: 10.1016/j.acuro.2017.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 04/28/2017] [Indexed: 01/01/2023]
Abstract
INTRODUCTION AND OBJECTIVES This review article focuses on the prevention and management of the most common postoperative urological complications of radical cystectomy. We reviewed the current literature and conducted an analysis of frequency, prevention and treatment of complications. ACQUISITION OF EVIDENCE We conducted a search on Medline to identify original articles, literature reviews and editorials focusing on the urological complications of radical cystectomy during the first 90 days after surgery. We identified those series that included more than 100 patients. SYNTHESIS OF THE EVIDENCE The literature regarding the prevention and treatment of complications after cystectomy is in general retrospective and nonstandardised. The level of evidence is generally low, and it is difficult to make evidence-based recommendations. CONCLUSIONS Progress has been made in recent years in reducing mortality and preventing the complications of cystectomy. The most common complications are gastrointestinal, for which significant efforts have been made to implement ERAS and Fast Track protocols. The complications that can most significantly change patients' quality of life are urinary stoma.
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16
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North America Wound, Ostomy, and Continence and Enterostomal Therapy Nurses Current Ostomy Care Practice Related to Peristomal Skin Issues. J Wound Ostomy Continence Nurs 2017; 44:257-261. [PMID: 28362656 PMCID: PMC5417579 DOI: 10.1097/won.0000000000000324] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to describe the practice of 796 ostomy nurses in North America in 2014 related to peristomal skin issues. DESIGN Descriptive study. SUBJECTS AND SETTING Participants were 796 wound, ostomy, and continence (WOC) and enterostomal therapy (ET) nurses currently practicing in the United States or Canada and caring for patients with ostomies. The collection of data occurred in conjunction with an educational program on peristomal skin complications and practice issues and solicited the participant's perception on the incidence and frequency of peristomal skin issues as well as on practice patterns. METHODS Participants attended an educational program. They were also asked to anonymously respond to multiple-choice questions on ostomy care management via an audience response system followed by discussion of each item and their responses. This descriptive study reports on the answers to the questions as well as the pertinent discussion points. RESULTS Participants estimated that approximately 77.70% of their patients developed peristomal skin issues. The most commonly encountered problem was irritant contact dermatitis (peristomal moisture-associated skin damage). Contributing factors were inappropriate use of a pouching system owing to lack of follow-up after hospital discharge. Reported interventions for the prevention and management of peristomal skin issues included preoperative stoma site marking, use of a convex pouching system, and barrier rings. However, subsequent discussion revealed that the frequency of use of these products varied considerably. Participants identified shortened hospital stays, absence of preoperative stoma marking, and limited outpatient follow-up as contributing to development of peristomal skin problems. CONCLUSION WOC and ET nurses estimate that more than three-quarters of persons living with an ostomy develop peristomal skin problems. Multiple interventions for managing these problems were identified, but some variability in management approaches emerged.
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Franklyn J, Varghese G, Mittal R, Rebekah G, Jesudason MR, Perakath B. A prospective randomized controlled trial comparing early postoperative complications in patients undergoing loop colostomy with and without a stoma rod. Colorectal Dis 2017; 19:675-680. [PMID: 28067986 DOI: 10.1111/codi.13600] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 09/09/2016] [Indexed: 12/16/2022]
Abstract
AIM A stoma rod or bridge has been traditionally placed under the bowel loop while constructing a loop colostomy. This is believed to prevent stomal retraction and provide better faecal diversion. However, the rod can cause complications such as mucosal congestion, oedema and necrosis. This single-centre prospective randomized controlled trial compared outcomes after creation of loop colostomy with and without a supporting stoma rod. The primary outcome studied was stoma retraction rate; other stoma-related complications were studied as secondary outcomes. METHOD One hundred and fifty-one patients were randomly allotted to one of two arms, colostomy with or without a supporting rod. Postoperative complications such as retraction, mucocutaneous separation, congestion and re-exploration for stoma-related complications were recorded. RESULTS There was no difference in the stoma retraction rate between the two arms (8.1% in the rod arm and 6.6% in the no-rod arm; P = 0.719). Stomal necrosis (10.7% vs 1.3%; P = 0.018), oedema (23% vs 3.9%; P = 0.001), congestion (20.3% vs 2.6%; P = 0.001) and re-admission rates (8.5% vs 0%; P = 0.027) were significantly increased in the arm randomized to the rod. CONCLUSION The stoma rod does not prevent stomal retraction. However, complication rates are significantly higher when a stoma rod is used. Routine use of a stoma rod for construction of loop colostomy can be avoided.
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Affiliation(s)
- J Franklyn
- Department of Surgery Unit 2 (Colorectal Surgery), Christian Medical College, Vellore, India
| | - G Varghese
- Department of Surgery Unit 2 (Colorectal Surgery), Christian Medical College, Vellore, India
| | - R Mittal
- Department of Surgery Unit 2 (Colorectal Surgery), Christian Medical College, Vellore, India
| | - G Rebekah
- Department of Biostatistics, Christian Medical College, Vellore, India
| | - M R Jesudason
- Department of Surgery Unit 2 (Colorectal Surgery), Christian Medical College, Vellore, India
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Is the Use of a Support Bridge Beneficial for Preventing Stomal Retraction After Loop Ileostomy? A Prospective Nonrandomized Study. J Wound Ostomy Continence Nurs 2017; 42:368-73. [PMID: 26135822 DOI: 10.1097/won.0000000000000131] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE A temporary defunctioning loop ileostomy is frequently created during low colorectal or coloanal anastomosis to prevent peritoneal sepsis associated with anastomotic leakage. We investigated whether routine support bridge placement prevents stoma retraction after the formation of a loop ileostomy. DESIGN Prospective, nonrandomized trial. SUBJECTS AND SETTING The study sample comprised 32 consecutive patients who underwent defunctioning loop ileostomy at an academic tertiary care center in Seoul Korea from February to September 2010. METHODS Patients were nonrandomly allocated to "no bridge," "short-term bridge" (1 week), and "long-term bridge" (3 weeks) groups based on the surgeon's clinical judgment. Group differences in stoma height changes over time were analyzed. RESULTS Subjects' mean age was 59.5 (range: 43-82) years, and the male-to-female ratio was 2.2:1.0. The mean heights of the stoma on postoperative day 2 and postoperative month 3, respectively, were 1.07 ± 0.16 cm (mean ± SD) and 0.81 ± 0.17 cm in the no-bridge group, 1.70 ± 0.29 cm and 1.21 ± 0.18 cm in the short-term bridge group, and 1.18 ± 0.16 cm and 1.01 ± 0.20 cm in the long-term bridge group. The changes in the stoma height 3 months after the surgery showed no statistically significant differences among the groups (P = .430). Stoma Quality of Life scores at 3 weeks (47.4 vs 46.1; P = .730) were similar for patients with and without bridges. However, a significantly greater number of patients with bridges reported difficulty with pouch changes compared to those without bridges (72.7% vs 14.3%; P = .002). CONCLUSIONS Routine use of support bridges during loop ileostomy is unnecessary and inconvenient to patients. If a support bridge must be used, it can be removed early.
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The Impact of Preoperative Stoma Marking on Health-Related Quality of Life. J Wound Ostomy Continence Nurs 2016; 43:57-61. [DOI: 10.1097/won.0000000000000180] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lowry N, McLister A, McCreadie K, Davis J. An electronic approach to minimising moisture-associated skin damage in ostomy patients. Med Hypotheses 2015; 85:192-6. [PMID: 25981876 DOI: 10.1016/j.mehy.2015.04.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 04/25/2015] [Indexed: 12/01/2022]
Abstract
Marked developments in the design of ostomy appliances in recent years have revolutionised stoma care and management but the prevalence of peristomal skin complications continues to be problematic with incidence rates ranging from 10% to 70%. Despite requisite pre and post-operative education for new patients, complications continue to arise - even under the close supervision of specialist nurses. Prolonged exposure of the skin to high pH stoma effluent is widely accepted as a key contributor to the onset of moisture-associated skin disease and it is our hypothesis that a "smart wafer", employing electrochemical manipulation of local pH, could mitigate some of the issues currently plaguing ostomy management. Current electrochemical research strategies translatable to stoma care are presented and their possible implementations critically appraised.
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Affiliation(s)
- Naomi Lowry
- School of Engineering, University of Ulster, Jordanstown, Northern Ireland BT37 0QB, UK
| | - Anna McLister
- School of Engineering, University of Ulster, Jordanstown, Northern Ireland BT37 0QB, UK
| | - Karl McCreadie
- School of Engineering, University of Ulster, Jordanstown, Northern Ireland BT37 0QB, UK
| | - James Davis
- School of Engineering, University of Ulster, Jordanstown, Northern Ireland BT37 0QB, UK.
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The incidence of stoma and peristomal complications during the first 3 months after ostomy creation. J Wound Ostomy Continence Nurs 2014; 40:400-6. [PMID: 23820472 DOI: 10.1097/won.0b013e318295a12b] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE The purpose of this study was to examine stoma and peristomal complications and related variables among adults with ostomies. The primary study aim was to determine the incidence of peristomal and stoma complications during the first 3 months after stoma creation. DESIGN Data were collected using a prospective, repeated-measures descriptive study design. SUBJECTS AND SETTING Data were collected at 2 university-based hospitals with outpatient ostomy clinics in the Midwestern United States. The sample included 43 adults with newly created colostomy, ileostomy, or urostomy stomas. METHODS Participants were examined for the presence of complications up to 4 times during a 3-month period: within 7 days of surgery. Patients were also evaluated at 2, 6, and 12 weeks after stoma creation. Data were collected using a validated instrument with acceptable interrater reliability. RESULTS Peristomal skin complications developed in 27 participants, comprising 63% of the sample. The onset of peristomal skin complications occurred most frequently during the 21- to 40-day time period. The most common skin conditions at nearly all time intervals were irritation (peristomal moisture-associated skin damage) and infection. Of the 18 participants observed 70 days or longer, just 7 (38%) remained free of peristomal skin complications throughout the study. Six participants developed 1 or more stoma complications, all of which occurred 20 or more days after surgery. No demographic or clinical factors were found to be associated with the development of complications. CONCLUSIONS Although the participants were evaluated at regular intervals by a specialized nurse, the majority experienced peristomal skin complications. These results underscore the importance of further work in interventions to prevent and treat peristomal skin complications and to provide ongoing outpatient follow-up to individuals with stomas.
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Scientific and Clinical Abstracts From the WOCN® Society's 46th Annual Conference. J Wound Ostomy Continence Nurs 2014. [DOI: 10.1097/won.0000000000000037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Affiliation(s)
- Jennie Burch
- former stoma care nurse, enhanced recovery nurse at St Mark's Hospital, Harrow, Middlesex
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Looking back: a review of classic ostomy literature in the WOCN society's official publication. J Wound Ostomy Continence Nurs 2013; 40:343-8. [PMID: 23820467 DOI: 10.1097/won.0b013e318299f747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In recognition of the 40-year anniversary of the Journal of Wound, Ostomy and Continence Nursing, a review of ostomy-related articles in the Society's official publications was done. The goal was to find what were considered classic ostomy articles, articles that contributed to the practice of ostomy care nursing, and articles that as clinicians practicing in the late 70s we felt helped to shape the future of ostomy care nursing. The review began with the 1975 ET Journal and continued forward ending in 1990. A classic article was defined as one that described a new or unique use of an ostomy product, a new procedure that impacted ostomy practice, the evolution of evidence-based ostomy practice, concepts that would drive our future practice, and management of stoma complications. These articles are a glimpse into the unique, creative, and evolving practice that makes our ostomy specialty distinctive.
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Peristomal Moisture–Associated Skin Damage in Adults With Fecal Ostomies. J Wound Ostomy Continence Nurs 2013; 40:389-99. [DOI: 10.1097/won.0b013e3182944340] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Evaluation of a cyanoacrylate dressing to manage peristomal skin alterations under ostomy skin barrier wafers. J Wound Ostomy Continence Nurs 2012; 38:676-9. [PMID: 22101798 DOI: 10.1097/won.0b013e318234550a] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Peristomal skin alterations under ostomy barrier wafers are a commonly reported problem. While a number of interventions to manage this issue have been reported, the use of a topically applied cyanoacrylate has received little attention. This case series describes the use of a topical cyanoacrylate for the management of peristomal skin alterations in persons living with an ostomy. CASE PRESENTATIONS Using a convenience sample, the topical cyanoacrylate dressing was applied to 11 patients with peristomal skin disruption under ostomy wafers in acute care and outpatient settings. The causes of barrier function interruption were also addressed to enhance outcomes. Patients were assessed for wound discomfort using a Likert Scale, time to healing, and number of appliance changes. Patient satisfaction was also examined. CONCLUSION Average reported discomfort levels were 9.5 out of 10 at the initial peristomal irritation assessment visit decreased to 3.5 at the first wafer change and were absent by the second wafer change. Wafers had increasing wear time between changes in both settings with acute care patients responding faster. Epidermal resurfacing occurred within 10.2 days in outpatients and within 7 days in acute care patients. Because of the skin sealant action of this dressing, immediate adherence of the wafer was reported at all pouch changes.
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Zeigler M. How do we promote independent ostomy management for people with disability? Rehabil Nurs 2012; 37:53-5. [PMID: 22434613 DOI: 10.1002/rnj.00009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE To describe how people with ostomies became independent with their ostomy management. METHOD Two clinical ostomy consultations which incorporated traditional ostomy management along with state-of-the-art ostomy technology aimed at the needs of the disabled person. RESULTS The newer technologies eliminated several of the traditional steps and made a one-handed approach possible. DISCUSSION This article describes two clinical consultations which incorporated traditional ostomy management along with state-of-the-art ostomy technology aimed at the needs of the disabled person. Peristomal skin preparation and protection, barrier wafer preparation, proper pouch emptying, and newer technology are discussed. CONCLUSION The consultations resulted in ostomy care autonomy and an improved quality of life in both patients.
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Affiliation(s)
- Mary Zeigler
- Rehabilitation Institute of Chicago-Nursing, Chicago, IL 60611, USA.
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Milne CT, Paine T, Sullivan V, Sawyer A. Content validation of terms and definitions in a wound glossary. J Am Coll Clin Wound Spec 2011; 3:71-6. [PMID: 24527368 DOI: 10.1016/j.jcws.2012.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE A common language and lexicon provide the easiest means of mutual understanding. Inconsistency in terminology makes effective information exchange difficult. Previous studies identified the need to determine standard, accepted definitions for the vocabulary frequently used in wound care. The objective of this study was to establish content validation for these terms and develop an evidence-based glossary for this specialty. METHODS Members of the Association for the Advancement of Wound Care Quality of Care Task Force reviewed literature to determine glossary content generation and the associated literature-based definitions. Thirty-nine wound care professionals from wound care stakeholder professional organizations in the United States and Canada participated in the content validation process. Participants were asked to quantify the degree of validity using a 367-item, 4-point Likert-type scale. RESULTS On a scale of 1 to 4, the mean score of the entire instrument was 3.84. The instrument's overall scale content validity index was 0.96. Terms with an item content validity index of less than 0.70 were removed from the glossary, leaving 365 items with established content validity. Qualitative data analysis revealed themes suggesting that enhanced communication between providers improves patient outcomes. The need for ongoing updates of the glossary was also identified. CONCLUSION The wound care glossary in its finalized form proved valid. An evidence-based glossary bridges the chasm of miscommunication and nonstandardization so that wound care, as an emerging specialized medical science field, can move forward to optimize both process and clinical outcomes.
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Affiliation(s)
- Catherine T Milne
- Association for Advancement in Wound Care, Quality of Care Committee
| | - Tim Paine
- Association for Advancement in Wound Care, Quality of Care Committee
| | - Valerie Sullivan
- Association for Advancement in Wound Care, Quality of Care Committee
| | - Allen Sawyer
- Association for Advancement in Wound Care, Quality of Care Committee
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Context for WOC practice: validating our assessments and interventions. J Wound Ostomy Continence Nurs 2010; 37:455-7. [PMID: 20838309 DOI: 10.1097/won.0b013e3181ee3af1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ratliff CR. Early Peristomal Skin Complications Reported by WOC Nurses. J Wound Ostomy Continence Nurs 2010; 37:505-10. [DOI: 10.1097/won.0b013e3181edac57] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Early postoperative complications following ostomy surgery: a review. J Wound Ostomy Continence Nurs 2009; 36:513-9; quiz 520-1. [PMID: 19752661 DOI: 10.1097/won.0b013e3181b35eaa] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article reviews early postoperative complications in adults undergoing ostomy surgery. Whether the ostomy is the result of an emergent or elective procedure, the WOC nurse and staff nurses are responsible for monitoring and ensuring quality healthcare for the patient. Nevertheless, many patients undergoing ostomy surgery experience a complication during the early postoperative period. Early postoperative complications not only influence immediate postoperative care but may also impact quality of life for the person living with an ostomy. Keen assessment skills, early recognition of signs and symptoms of a complication, and prompt interventions are crucial to maintaining a viable stoma and a successful surgical outcome.
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Demographic and clinical factors related to ostomy complications and quality of life in veterans with an ostomy. J Wound Ostomy Continence Nurs 2009; 35:493-503. [PMID: 18794701 DOI: 10.1097/01.won.0000335961.68113.cb] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study is to describe demographic, clinical, and quality-of-life variables related to ostomy complications (skin irritation, leakage, and difficulty adjusting to an ostomy) in a veteran population in the United States. DESIGN The original study employed a descriptive crosssectional study using a mixed method design. This secondary analysis used the quantitative data collected. SAMPLE AND SETTING Two hundred thirty-nine veterans with intestinal ostomies from 3 Veteran's Administration hospitals participated in the study. METHODS Instruments used for this investigation included the City of Hope Quality of Life: Ostomy Instrument. Demographic and medical history data were collected from the survey, the Veteran's Administration health information system, and the Tumor Registry database. A self-administered survey questionnaire (mCOH-QOL-Ostomy) was mailed to each participant. RESULTS The severity of skin irritation, problems with leakage, and difficulty adjusting were significantly related to demographic, clinical, and quality-of-life domains. Univariate analyses showed that age, income, employment, preoperative care (stoma site marking and education), having a partner, ostomy type, reason for ostomy, time since surgery, total quality-of-life scores and scores on all 4 domains of quality of life were related to the severity of these ostomy complications. Age was inversely related to severity of all 3 ostomy complications (skin irritation, leakage, and difficulty adjusting). Having an ileostomy, rather than a colostomy, was associated with higher severity of skin irritation. Having had the stoma site marked preoperatively was associated with less difficulty adjusting to an ostomy, and having had preoperative ostomy education was associated with less severe problems with skin irritation and leakage. Severity of each ostomy complication predicted total quality-of-life scores. Difficulty adjusting to the ostomy was related to all 4 quality-of-life domains (physical, psychological, social, and spiritual). CONCLUSIONS This study found important relationships between demographic and clinical factors and ostomy complications. Skin problems, leakage, and difficulty adjusting predicted total quality of life scores and domains. Establishing relationships among ostomy complications and demographic, clinical factors, and quality of life can enhance identification of patients at risk for the development of complications and is an important first step in identifying the development of effective interventions to reduce the negative impact of complications for people with ostomies. Further study of predictors and outcomes of ostomy complications is needed to improve care.
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Incidence of Complications of the Stoma and Peristomal Skin Among Individuals with Colostomy, Ileostomy, and Urostomy. J Wound Ostomy Continence Nurs 2008; 35:596-607; quiz 608-9. [DOI: 10.1097/01.won.0000341473.86932.89] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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