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Guerra E, Denti FC, Di Pasquale C, Caroppo F, Angileri L, Cioni M, Parodi A, Fortina AB, Ferrucci S, Burlando M. Peristomal Skin Complications: Detailed Analysis of a Web-Based Survey and Predictive Risk Factors. Healthcare (Basel) 2023; 11:1823. [PMID: 37444657 DOI: 10.3390/healthcare11131823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/27/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Patients with a stoma are at risk of developing peristomal skin complications (PSCs) that can negatively impact their quality of life. This study aims to identify potential risk factors for dermatitis, pruritis/xerosis, infections, and ulcerations among patients with a stoma and evaluate preventive measures. This cross-sectional study involved data regarding 232 Italian patients with a stoma. A questionnaire was used to collect patient characteristics, comorbidities, and stoma management data. The most frequent PSCs observed were dermatitis and pruritis/xerosis in approximately 60% of patients. Psoriasis was strongly correlated with dermatitis, while being overweight or obese increased the risk of pruritis/xerosis. Class 2 obesity and atopic dermatitis were associated with an increased risk of infections. Being underweight, completely nonautonomous, and having inflammatory bowel disease were associated with a higher risk of ulcerations, while radiotherapy was a strong risk factor for ulceration. Preventive measures such as using hydrocolloid barriers, TNT gauze cleansing, and low pH detergent were effective in preventing dermatitis. Appropriate stoma care and maintenance, including the use of protective film and careful monitoring of weight and comorbidities, are crucial in minimizing the risk of complications associated with a stoma.
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Affiliation(s)
- Eliana Guerra
- Ambulatorio Riabilitazione Enterostomale, ASST Spedali Civili Brescia, 25123 Brescia, Italy
| | | | - Cristina Di Pasquale
- Stomal Therapy Outpatient Service, European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Francesca Caroppo
- Unit of Dermatology, Department of Medicine DIMED, University of Padua, 35128 Padua, Italy
| | - Luisa Angileri
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Margherita Cioni
- St Mary's Hospital, Imperial College NHS Trust, London W2 1NY, UK
| | - Aurora Parodi
- Di.S.Sal. Section of Dermatology, IRCCS San Martino Polyclinic Hospital, Largo Rosanna Benzi 10, 16100 Genoa, Italy
| | - Anna Belloni Fortina
- Unit of Dermatology, Department of Medicine DIMED, University of Padua, 35128 Padua, Italy
| | - Silvia Ferrucci
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Martina Burlando
- Di.S.Sal. Section of Dermatology, IRCCS San Martino Polyclinic Hospital, Largo Rosanna Benzi 10, 16100 Genoa, Italy
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D’Ambrosio F, Pappalardo C, Scardigno A, Maida A, Ricciardi R, Calabrò GE. Peristomal Skin Complications in Ileostomy and Colostomy Patients: What We Need to Know from a Public Health Perspective. Int J Environ Res Public Health 2022; 20:ijerph20010079. [PMID: 36612395 PMCID: PMC9819694 DOI: 10.3390/ijerph20010079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 05/31/2023]
Abstract
BACKGROUND Peristomal skin complications (PSCs) are the most common skin problems seen after ostomy surgery. They have a considerable impact on a patient's quality of life and contribute to a higher cost of care. METHODS A systematic review was conducted, querying three databases. The analysis was performed on international studies focused on the clinical-epidemiological burden of PSCs in adult patients with ileostomy/colostomy. RESULTS Overall, 23 studies were considered. The main diseases associated with ostomy surgery were rectal, colon and gynecological cancers, inflammatory bowel diseases, diverticulitis, bowel obstruction and intestinal perforation. Erythema, papules, skin erosions, ulcers and vesicles were the most common PSCs for patients with an ostomy (or stoma). A PSCs incidence ranging from 36.3% to 73.4% was described. Skin complications increased length of stay (LOS) and rates of readmission within 120 days of surgery. CONCLUSIONS PSCs data are still limited. A knowledge of their burden is essential to support health personnel and decision-makers in identifying the most appropriate responses to patients' needs. Proper management of these complications plays a fundamental role in improving the patient's quality of life. A multidisciplinary approach, as well as increased patient education and their empowerment, are priority measures to be implemented to foster a value-based healthcare.
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Affiliation(s)
- Floriana D’Ambrosio
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ciro Pappalardo
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Anna Scardigno
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Ada Maida
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Roberto Ricciardi
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giovanna Elisa Calabrò
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- VIHTALI (Value in Health Technology and Academy for Leadership & Innovation), Spin-Off of Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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4
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Stoia-Davis J, Colwell JC, Emodi K, Fellows J, Mahoney M, McDade B, Porten SP, Raskin ER, Norman HS, Kelly MT, Sims T. Survey Results on Use of a Convex Pouching System in the Postoperative Period. J Wound Ostomy Continence Nurs 2022; 49:247-250. [PMID: 35523240 PMCID: PMC9093726 DOI: 10.1097/won.0000000000000877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to validate time frames for postoperative care following stoma surgery and to determine participants' current practice with convex pouching systems during the postoperative period. DESIGN A Cross-sectional survey. SUBJECTS AND SETTING The sample comprised 332 ostomy care specialists practicing in the United States. Most (n = 220; 66%) had more than 10 years' experience caring for patients with ostomies, 82% (n = 272) were certified WOC or ostomy care nurses (CWOCN and COCN), and 7% (n = 23) were board-certified colorectal surgeons. METHODS A 23-item online questionnaire was created for purposes of the study. Items in the questionnaire queried professional background and experience caring for patients with an ostomy. A single item was used to identify postoperative care periods following ostomy surgery. Additional items queried current practice patterns related to use of convex pouching systems and the timing of their use. Data were collected from January 18 to February 8, 2021. RESULTS Most respondents (n = 270; 90%) agreed with the following postoperative periods after ostomy surgery: immediate postoperative period (days 0-8); postoperative period (days 9-30); and transition phase (days 31-180). Most respondents (n = 274; 95%) indicated they would use a convex pouching system when clinically appropriate during the first 30 days following ostomy surgery and 79% (n = 228) indicated using a convex pouching system regardless of when the surgery was performed. Less than 1% (n = 2) indicated never using convexity within the first 30 days following stoma surgery, and only 3% (n = 8) indicated avoidance of convexity pouching systems in the immediate postoperative period. CONCLUSIONS Findings indicate that use of convexity during the postoperative period is prevalent to provide a secure seal and predictable wear time.
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Affiliation(s)
- Janet Stoia-Davis
- Correspondence: Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, 18038 Twin Lakes Dr, Riverside, CA 92508 ()
| | - Janice C. Colwell
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- 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, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Krisztina Emodi
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- 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, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Jane Fellows
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- 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, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Mary Mahoney
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- 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, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Bethany McDade
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- 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, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Sima P. Porten
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- 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, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Elizabeth R. Raskin
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- 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, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Holly S. Norman
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- 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, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Matthew T. Kelly
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- 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, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
| | - Terran Sims
- Janet Stoia-Davis, RN, CWOCN, FCN, Stoia Consultants, Riverside, California
- Janice C. Colwell, APRN, CWOCN, FAAN, Department of Surgery, University of Chicago Medicine, Chicago, Illinois
- Krisztina Emodi, NP-C, MPH, CNS, University of California San Francisco, San Francisco, California
- 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, RN, AGPCNP-BC, CWON, Beaumont Health, Southfield, Michigan
- Sima P. Porten, MD, MPH, FACS, University of California San Francisco, San Francisco, California
- Elizabeth R. Raskin, MD, FACS, FASCRS, University of California Davis, Davis, California
- Holly S. Norman, PhD, MBA, Coloplast, Minneapolis, Minnesota
- Matthew T. Kelly, PhD, Coloplast, Minneapolis, Minnesota
- Terran Sims, MSN, ACNP-C, CNN, COCN-C, University of Virginia, Charlottesville, Virginia
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5
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Andersen NK, Trøjgaard P, Herschend NO, Størling ZM. Automated Assessment of Peristomal Skin Discoloration and Leakage Area Using Artificial Intelligence. Front Artif Intell 2021; 3:72. [PMID: 33733189 PMCID: PMC7861335 DOI: 10.3389/frai.2020.00072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/05/2020] [Indexed: 01/22/2023] Open
Abstract
For people living with an ostomy, development of peristomal skin complications (PSCs) is the most common post-operative challenge. A visual sign of PSCs is discoloration (redness) of the peristomal skin often resulting from leakage of ostomy output under the baseplate. If left unattended, a mild skin condition may progress into a severe disorder; consequently, it is important to monitor discoloration and leakage patterns closely. The Ostomy Skin Tool is current state-of-the-art for evaluation of peristomal skin, but it relies on patients visiting their healthcare professional regularly. To enable close monitoring of peristomal skin over time, an automated strategy not relying on scheduled consultations is required. Several medical fields have implemented automated image analysis based on artificial intelligence, and these deep learning algorithms have become increasingly recognized as a valuable tool in healthcare. Therefore, the main objective of this study was to develop deep learning algorithms which could provide automated, consistent, and objective assessments of changes in peristomal skin discoloration and leakage patterns. A total of 614 peristomal skin images were used for development of the discoloration model, which predicted the area of the discolored peristomal skin with an accuracy of 95% alongside precision and recall scores of 79.6 and 75.0%, respectively. The algorithm predicting leakage patterns was developed based on 954 product images, and leakage area was determined with 98.8% accuracy, 75.0% precision, and 71.5% recall. Combined, these data for the first time demonstrate implementation of artificial intelligence for automated assessment of changes in peristomal skin discoloration and leakage patterns.
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Kimberly L, Whiteley I, McNichol L, Salvadalena G, Gray M. Peristomal Medical Adhesive-Related Skin Injury: Results of an International Consensus Meeting. J Wound Ostomy Continence Nurs 2019; 46:125-136. [PMID: 30844869 PMCID: PMC6519893 DOI: 10.1097/won.0000000000000513] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Stomal and peristomal skin complications (PSCs) are prevalent in persons living with an ostomy; more than 80% of individuals with an ostomy will experience a stomal or peristomal complication within 2 years of ostomy surgery. Peristomal skin problems are especially prevalent, and a growing body of evidence indicates that they are associated with clinically relevant impairments in physical function, multiple components of health-related quality of life, and higher costs. Several mechanisms are strongly linked to PSCs including medical adhesive-related skin injuries (MARSIs). Peristomal MARSIs are defined as erythema, epidermal stripping or skin tears, erosion, bulla, or vesicle observed after removal of an adhesive ostomy pouching system. A working group of 3 clinicians with knowledge of peristomal skin health completed a scoping review that revealed a significant paucity of evidence regarding the epidemiology and management of peristomal MARSIs. As a result, an international panel of experts in ostomy care and peristomal MARSIs was convened that used a formal process to generate consensus-based statements providing guidance concerning the assessment, prevention, and treatment of peristomal MARSIs. This article summarizes the results of the scoping review and the 21 consensus-based statements used to guide assessment, prevention, and treatment of peristomal MARSIs, along with recommendations for research priorities.
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Affiliation(s)
- LeBlanc Kimberly
- Correspondence: Kimberly LeBlanc, PhD, RN, NSWOC, WOCC(C), Association for Nurses Specialized in Wound Ostomy Continence Canada (NSWOCC), 66 Leopolds Dr, Ottawa, ON K1V 7E3, Canada ()
| | - Ian Whiteley
- Kimberly LeBlanc, PhD, RN, NSWOC, WOCC(C), Wound Ostomy Continence Institute, Association for Nurses Specialized in Wound Ostomy Continence Canada (NSWOCC), Ottawa, Ontario, Canada
- Ian Whiteley, MNurs, NP, STN, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN, Cone Health, Greensboro, North Carolina
- Ginger Salvadalena, PhD, RN, Clinical Affairs, Hollister Incorporated, Libertyville, Illinois
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, School of Medicine (Department of Urology) and School of Nursing (Department of Acute and Specialty Practice), University of Virginia, Charlottesville, Illinois
| | - Laurie McNichol
- Kimberly LeBlanc, PhD, RN, NSWOC, WOCC(C), Wound Ostomy Continence Institute, Association for Nurses Specialized in Wound Ostomy Continence Canada (NSWOCC), Ottawa, Ontario, Canada
- Ian Whiteley, MNurs, NP, STN, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN, Cone Health, Greensboro, North Carolina
- Ginger Salvadalena, PhD, RN, Clinical Affairs, Hollister Incorporated, Libertyville, Illinois
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, School of Medicine (Department of Urology) and School of Nursing (Department of Acute and Specialty Practice), University of Virginia, Charlottesville, Illinois
| | - Ginger Salvadalena
- Kimberly LeBlanc, PhD, RN, NSWOC, WOCC(C), Wound Ostomy Continence Institute, Association for Nurses Specialized in Wound Ostomy Continence Canada (NSWOCC), Ottawa, Ontario, Canada
- Ian Whiteley, MNurs, NP, STN, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN, Cone Health, Greensboro, North Carolina
- Ginger Salvadalena, PhD, RN, Clinical Affairs, Hollister Incorporated, Libertyville, Illinois
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, School of Medicine (Department of Urology) and School of Nursing (Department of Acute and Specialty Practice), University of Virginia, Charlottesville, Illinois
| | - Mikel Gray
- Kimberly LeBlanc, PhD, RN, NSWOC, WOCC(C), Wound Ostomy Continence Institute, Association for Nurses Specialized in Wound Ostomy Continence Canada (NSWOCC), Ottawa, Ontario, Canada
- Ian Whiteley, MNurs, NP, STN, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN, Cone Health, Greensboro, North Carolina
- Ginger Salvadalena, PhD, RN, Clinical Affairs, Hollister Incorporated, Libertyville, Illinois
- Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, School of Medicine (Department of Urology) and School of Nursing (Department of Acute and Specialty Practice), University of Virginia, Charlottesville, Illinois
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Abstract
Intestinal stomas are necessary for several colon and rectal conditions and represent a major change in the new ostomate's daily life. Though dehydration is the most frequent etiology requiring readmission, irritant contact dermatitis and a host of other peristomal skin conditions are more common complications for ostomates. Wound, ostomy, and continence nurses are invaluable resources to both ostomy patients and providers. A few simple interventions can prevent or resolve most common peristomal complications. Good stoma care is possible in a resource-poor environment.
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Affiliation(s)
- Emily Steinhagen
- Division of Colon and Rectal Surgery, Department of Surgery, University Hospitals Case Medical Center, Cleveland, Ohio
| | - Janice Colwell
- Section of Colon and Rectal Surgery, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
| | - Lisa M Cannon
- Section of Colon and Rectal Surgery, Department of General Surgery, University of Chicago Medicine, Chicago, Illinois
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