Stoma complications before and after the introduction of stoma siting performed by nurses: a retrospective study

Authors

DOI:

https://doi.org/10.54103/dn/17946

Keywords:

stoma siting, complications, nurse, stomatherapist, stomatherapy

Abstract

BACKGROUND: 3%-82% of stoma patients suffer from ostomy complications, which determine an increased assistance burden with the lengthening of the hospital stay and of the time needed to recover the autonomy of the stoma. Literature shows that the lack of a preoperative stoma design is one of the factors increasing the bearing of ostomy complications, along with the urgency of the operation, the height and type of the stoma, and body mass index.

AIM: Evaluating the number and characteristics of ostomy complications in the period before the introduction of the preoperative ostomy design procedure (i.e. stoma siting) performed by the nurse. Comparing these numbers with those concerning complications detected in the period after the introduction of the stoma siting procedure.

METHODS: Monocentric retrospective observational study, in the operating units of General Surgery and Urology of San Paolo hospital of ASST Santi Paolo e Carlo, Milan. Convenience samples of patients undergoing enteral and urinary ostomy. 

RESULTS: 264 patients were recruited. 51.1% had experienced ostomy complications; 42.9% of them had undergone stoma siting, 61.5% had not. The most frequent complications were peristomal skin changes (29.9%). The difference in numbers between the individual types of complications in the two groups is clinically relevant.

CONCLUSIONS: Stoma siting is a nursing procedure that, if well performed, leads to the reduction of ostomy complications. It is the nurse’s responsibility to ensure each patient who undergoes ostomy packing the correct execution of the ostomy design – whenever the conditions of the clinical picture allow it.

References

Maglio A, Malvone AP, Scaduto V, Brambilla D, Denti FC. The frequency of early stomal, peristomal and skin complications. Br J Nurs. 2021 Dec;30(22):1272–6.

Anderson CB, McKiernan JM. Surgical Complications of Urinary Diversion. Urol Clin North Am. 2018 Feb;45(1):79–90.

Szymanski KM, St-Cyr D, Alam T, Kassouf W. External stoma and peristomal complications following radical cystectomy and ileal conduit diversion: a systematic review. Ostomy Wound Manage. 2010 Jan;56(1):28–35.

Pandiaraja J, Chakkarapani R, Arumugam S. A study on patterns, indications, and complications of an enteric stoma. J Fam Med Prim care. 2021 Sep;10(9):3277–82.

Bosio G, Pisani F, Fonti A, Scrocca A, Morandell C, Anselmi L. Studio osservazionale multicentrico sulle alterazioni cutanee post-enterostomie (SACS). Classificazione delle alterazioni peristomali. G di Chir. 2006;27(6/7):251–4.

Malik T, Lee MJ, Harikrishnan AB. The incidence of stoma related morbidity - a systematic review of randomised controlled trials. Ann R Coll Surg Engl. 2018 Sep;100(7):501–8.

Taneja C, Netsch D, Rolstad BS, Inglese G, Lamerato L, Oster G. Clinical and Economic Burden of Peristomal Skin Complications in Patients With Recent Ostomies. J wound, ostomy, Cont Nurs Off Publ Wound, Ostomy Cont Nurses Soc. 2017;44(4):350–7.

Parmar KL, Zammit M, Smith A, Kenyon D, Lees NP. A prospective audit of early stoma complications in colorectal cancer treatment throughout the Greater Manchester and Cheshire colorectal cancer network. Color Dis Off J Assoc Coloproctology Gt Britain Irel. 2011 Aug;13(8):935–8.

Qureshi A, Cunningham J, Hemandas A. Emergency stomas; should non-colorectal surgeons be doing it? Gastroenterol Hepatol from bed to bench. 2018;11(4):306–12.

Pengelly S, Reader J, Jones A, Roper K, Douie WJ, Lambert AW. Methods for siting emergency stomas in the absence of a stoma therapist. Ann R Coll Surg Engl. 2014 Apr;96(3):216–8.

Hsu M-Y, Lin J-P, Hsu H-H, Lai H-L, Wu Y-L. Preoperative Stoma Site Marking Decreases Stoma and Peristomal Complications: A Meta-analysis. J wound, ostomy, Cont Nurs Off Publ Wound, Ostomy Cont Nurses Soc. 2020;47(3):249–56.

Ayik C, Özden D, Cenan D. Ostomy Complications, Risk Factors, and Applied Nursing Care: A Retrospective, Descriptive Study. Wound Manag Prev. 2020 Sep;66(9):20–30.

Shabbir J, Britton DC. Stoma complications: a literature overview. Color Dis Off J Assoc Coloproctology Gt Britain Irel. 2010 Oct;12(10):958–64.

Kugler CM, Breuing J, Rombey T, Hess S, Ambe P, Grohmann E, et al. The effect of preoperative stoma site marking on risk of stoma-related complications in patients with intestinal ostomy—protocol of a systematic review and meta-analysis. Syst Rev. 2021;10(1):1–8.

Arolfo S, Borgiotto C, Bosio G, Mistrangelo M, Allaix ME, Morino M. Preoperative stoma site marking: a simple practice to reduce stoma-related complications. Tech Coloproctol. 2018 Sep;22(9):683–7.

Baykara ZG, Demir SG, Karadag A, Harputlu D, Kahraman A, Karadag S, et al. A multicenter, retrospective study to evaluate the effect of preoperative stoma site marking on stomal and peristomal complications. Ostomy Wound Manage. 2014 May;60(5):16–26.

Koc U, Karaman K, Gomceli I, Dalgic T, Ozer I, Ulas M, et al. A Retrospective Analysis of Factors Affecting Early Stoma Complications. Ostomy Wound Manage. 2017 Jan;63(1):28–32.

Dei N, Dello I, Agli S. Carta internazionale dei diritti degli stomizzati Assistenza agli stomizzati Erogazione dei presidi Invalidità. 2003;

Zelga P, Kluska P, Zelga M, Piasecka-Zelga J, Dziki A. Patient-Related Factors Associated With Stoma and Peristomal Complications Following Fecal Ostomy Surgery: A Scoping Review. J wound, ostomy, Cont Nurs Off Publ Wound, Ostomy Cont Nurses Soc. 2021;48(5):415–30.

Krishnamurty DM, Blatnik J, Mutch M. Stoma Complications. Clin Colon Rectal Surg. 2017 Jul;30(3):193–200.

Published

2022-07-29

How to Cite

Foresti, L. (2022). Stoma complications before and after the introduction of stoma siting performed by nurses: a retrospective study. Dissertation Nursing, 1(1). https://doi.org/10.54103/dn/17946
Received 2022-05-27
Accepted 2022-07-11
Published 2022-07-29