Peristomal Skin Complications in Ileostomy and Colostomy Patients: What We Need to Know from a Public Health Perspective
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Inclusion/Exclusion Criteria
2.3. Selection Process and Data Extraction
3. Results
3.1. Clinical-Epidemiological Burden of PSCs
3.2. Time of onset of PSCs
3.3. Classification and Assessment Tools
3.4. Risk Factors Related to PSCs
3.5. Hospital Admissions and Readmissions Related to PSCs
First Author, Year, [Ref.] | Study Type | N. of Included Studies | Type of Ostomy Surgery | Underlying Diseases Leading to Ostomy Surgery | Main Findings |
---|---|---|---|---|---|
Malik T.A.M, 2018, [38] | Systematic review | 18 trials | Ileostomy and Colostomy | Colorectal cancer, diverticular disease, fecal incontinence, constipation, irritable bowel syndrome, typhoid, tuberculosis, trauma, colovesical fistula and familial adenomatous polyposis syndrome | PSCs had the highest incidence across all ostomy types at 14.0% (2.4–46.2%), followed by parastomal hernia, which occurred in 5.5% of patients (0–88.2%). PSCs were most common in patients with a loop ileostomy (median 14.0%) and loop colostomy (median 32.3%). |
First Author, Year, Country, [Ref.] | Study Type | Sample Size and Population Characteristics | Type of Surgery (Ileo- or Colostomy) | Underlying Diseases | Epidemiological Data on PSCs | Type of PSCs and Related Data | Classification Tools | Risk Factors Related to PSCs | Time-to-Onset of PSCs | Hospitaladmissions/Readmissions/Other Healthcare Services Costs |
---|---|---|---|---|---|---|---|---|---|---|
Salvadalena G.D, 2013, US, [29] | Prospective study | Tot: 47 patients; M: 24 patients (51%); F: 23 patients (50%); Age: 47.6 ± 15.2 years (range 20–81 years) | Colostomy: 8 patients (17%); Ileostomy: 37 patients (79%); Urostomy: 2 patients (4%) | Ulcerative colitis; Crohn disease; Colorectal cancer; Perforated colon; Bladder cancer; Fistula; Others (Clostridium difficile colitis, indeterminate colitis, failed ileoanal pouch, familial adenomatous polyposis) | PSCs combined cumulative incidence: 63% | Moisture-associated skin damage: 14 patients; Skin infections (e.g., fungus or folliculitis): 11 patients; Erosion (excoriated; moist and bleeding): 8 patients; Erythema: 7 patients. | N.A. | N.A. | Most frequently 21–40 days after surgery ostomy | N.A. |
Lindholm E, 2013, Sweden, [30] | Prospective study | Tot: 144 patients; Mean age: 67 years (range 53.5–78 years) | End colostomy: 84 patients (58%); Loop colostomy: 10 patients (7%); End ileostomy: 26 patients (18%); Loop ileostomy: 24 patients (17%). | Diverticulitis: 41 patients (28%); Gynecological cancer: 28 patients (19%); Rectal cancer: 19 patients (14%); Colon cancer: 18 patients (13%); IBD: 15 patients (10%); Other types of cancers, fistulas, or sphincter rupture after delivery: 23 patients (16%). | PSCs Prevalence: at 3–6 months: 45%; at 12 months: 21%; at 24 months: 18%. | N.A. | Severe peristomal skin problems (classified as E++): 4–19% | N.A. | On ward: 9 patients (6.5%); After 2 weeks: 22 patients (19.3%); After 3 months: 14 patients (13.6%); After 6 months: 12 patients (16.9); After 1 year: 3 patients (5.3%); After 2 year: 1 patient (3.8%). | N.A. |
Baykara Z.G, 2014, Turkey, [22] | Retrospective study | Tot: 748 patients; M: 408 patients (54.5%); F: 340 patients (45.5%); Mean age: 56.60 ± 16.73 years. | Ileostomy: 363 patients (48.5%); Colostomy: 354 patients (47.3%) | Cancer: 545 patients (72.9%); IBD: 58 patients (7.8%); Bowel obstruction: 35 patients (4.7%); Injuries: 34 patients (4.5%); Intestinal perforation: 14 patients (1.9%); Fistula: 13 patients (1.7%) Familial adenomatous polyposis: 11 patients (1.5%); Anorectal malformation: 6 patients (0.8%); Mesenteric ischemia: 6 patients (0.8%); Sigmoid volvulus: 6 patients (0.8%); Intra-abdominal abscess: 4 patients (0.5%); Other: 16 patients (2.1%) | PSCs rate by type of surgery Emergency: 43 patients (19.5%); Planned: 93 patients (17.6%) | Peristomal skin problems: 136 (48.7%) Maceration: 2 (0.7%) Allergy: 1 (0.4%) | N.A. | Unplanned/ Emergency ostomy procedure; Multiple ostomies; Type of ostomy. | N.A. | N.A. |
Sarkut P, 2015, Turkey, [23] | Retrospective study | Tot: 141 patients; M: 95 patients (67%); F: 46 patients (33%); Mean age: 47 years (range: 17–67 years) | End ileostomy 43%; Loop ileostomy 46%; Double-barrel ileostomy 11%. | Benign causes: 48%; Malign causes: 52% | N.A. | Maceration in the peristomal skin: 10 patients | N.A. | N.A. | N.A. | N.A. |
Carlsson E, 2016, Sweden, [31] | Prospective Study | Tot: 207 patients; F: 53% Mean age: 70 years (range 19–94 years); Elective surgery: 74% | Colostomy: 146 patients (71%); End ileostomy: 54 patients (26%); Loop ileostomy: 7 patients (3%) | Colorectal cancer: 62%; IBD: 19% | PSCs prevalence: 23 patients (11%); PSCs with colostomy: 9 patients (6%); PSCs with an end or loop ileostomy: 14 patients (23%) | N.A. | Erythematous-erosive skin lesions (E+): 16 patients; Erythematous-erosive skin lesions (E++): 5 patients; Ulcerations (pyoderma gangrenosum): 2 patients | N.A. | N.A. | N.A. |
Cressey B.D, 2017, USA, [24] | Retrospective study | Tot: 18 patients; M: 11 patients; F: 7 patients; Mean age: 60.4 years (range: 35–87 years) | Colostomy: 9 patients; Ileostomy: 3 patients; Ileal conduit diversions: 6 patients | Cancer (colorectal: 7 patients; genitourinary: 6 patients; ovarian: 2 patients) | N.A. | Peristomal contact dermatitis: 12 patients; Erythematous extending out from the stoma: 18 patients; Erosion: 1 patient; Ulceration: 1 patient. | N.A. | N.A. | N.A. | N.A. |
Taneja C, 2017, US, [13] | Retrospective study | Tot: 128 patients; M: 67 patients (52.3%); F: 61 patients (47.7%); Mean Age: 60.6 ± 15.6 years | Colostomy: 51 patients (40%); Ileostomy: 64 patients (50%) | N.A. | PSCs incidence: 36.7% within 90 days following surgery [35.3% (n = 18) with colostomies; 43.8% (n = 28) with ileostomies]. | N.A. | N.A. | N.A. | Average time from surgery to first notation of PSCs: 23.7 ± 20.5 days; Colostomy: 23.2 ± 20.8 days; Ileostomy: 24.2 ± 21.1 days. | The mean length of stay for the index admission: 21.5 days for patients with PSCs vs. 13.9 days for all other patients. Readmissions: 22 patients (46.8%) with PSCs vs. 27 patients (33.3%) without PSCs; Readmissions for PSCs with colostomy: 8 patients (44.4%); Readmissions for PSCs with ileostomy: 14 patients (50.0%); Mean number of outpatient care visits: 11.4 (6.2%); Outpatient care visits for PSCs with colostomy: 13.4 (6.3%); Outpatient care visits for PSCs with ileostomy: 10.4 (5.7%); Mean number of home care visits: Home care visits for PSCs with colostomy: 9.2 (4.4%); -Home care visits for PSCs with ileostomy: 8.7 (5.0%). |
Harputlu D.U, 2018, Turkey, [32] | Prospective study | Tot: 35 patients; F: 22 patients (62.9%); Mean age: 57.45 ± 14.70 years; Intervention group (home care visits): 18 patients; Control group (outpatient/ clinic care): 17 patients | Ileostomy: 21 patients (60.0%); Permanent ostomy: 18 patients (51.4%); Unspecified ostomy: 8 patients (22.9%) | No chronic disease: 20 patients (57.1%); Rectal cancer: 14 patients (40%); Unspecified cause: 1 patient (2.9%) | N.A. | PSCs in Intervention group (Home nursing care): Irritant dermatitis: 12 patients (66.7%); 16.7% with a colostomy and 50% with an ileostomy. Mechanical trauma: 3 patients (16.7%); Allergic dermatitis: 2 patients (11.1%); Both allergic and irritant dermatitis: 1 patient (5.6%) PSCs in Control group (Outpatient/clinic care): Irritant dermatitis: 14 patients (82.4%); 23.5% with a colostomy and 58.8% with an ileostomy. Mechanical trauma: 2 patients (11.8%); Allergic dermatitis: 1 patient (5.9%) | Application of the OST to describe the severity, extent, and likely cause of a peristomal skin disorder | Diabetes mellitus; Immobility: Chemotherapy or/and radiotherapy | Irritant dermatitis in intervention group: appearance in the early postoperative period (0 to 29 days) in 2 patients with colostomy and 3 with ileostomy; Irritant dermatitis in control group: appearance in the early postoperative period (0 to 29 days) in 3 patients with ileostomy | N.A. |
Nichols TR, 2018 US, [34] | Cross-sectional study | M: 1230 patients; Mean age: 53.5 years (range 65.1 ±12.6 years); F: 1070 patients; Mean age: 46.5 years (range 61.8 ±13.4 years) | Ileostomy: 1031 patients (44.3%); Colostomy: 920 patients (39.5%); Urostomy: 308 patients (13.2%); Multiple types: 33 patients (1.4%) | N.A. | N.A. | Peristomal skin irritation | Self-report assessment: Level 1: peristomal skin integrity, no presence of irritated skin (n = 551 patients); Level 2: low to moderate level of reddening and irritation, occasional but slight blistering (n = 1029 patients); Level 3: severe irritation and reddening with severe blistering, denuded skin and ulceration (n = 427 patients). | N.A. | N.A. | N.A. |
Nichols & Inglese, 2018 US, [18] | Cross-sectional study | M: 1230 patients (53.48%); Mean age: 65.12 ± 12.62 years; F: 1030 patients (46.52%); Mean age: 61.77 ± 13.43 years | Colostomy: 920 patients (39.50%); Ileostomy: 1031 patients (44.27%); Urostomy: 308 patients (13.22%); Multiple stomas: 33 patients (1.42%); Unknown: 37 patients (1.59%) | N.A. | N.A. | Skin irritation | Self-report assessment: Intact (normal) skin: 551 patients; Mild to moderate skin irritation: 1029 patients; Severely irritated skin: 427 patients | N.A. | N.A. | N.A. |
Menin G, 2019, Italy, [5] | Cross-sectional study | Tot: 110 patients; M: 57 patients (51.8%); F: 53 patients (48.2%); Mean age: 69 years (range 19–90 years) | Ileostomy 47.3%; Colostomy 38.2%; Other types of procedures 14.5%. | Cancer: 58 patients (52.7%); Chronic intestinal inflammatory: 10 patients (9.1%); Diverticulitis: 9 patients (8.2%); Others: 33 patients 30% | N.A. | Erythema: 19 patients (17.3%); Papules: 2 patients (1.8%); Pustules: 2 patients (1.8%); Vesicles: 2 patients (1.8%); Bubbles (>0.5 mm): 1 patients (0.9%); Overgrowth of tissue: 14 patients (12.7%); Erosion: 36 patients (32.7%); Healing ulcer: 5 patients (4.6%); Mixed ulcer: 21 patients (19.1%); Worsening ulcer: 8 patients (7.3%) | The Peristomal Lesion Scale (PLS) vs. SACS Instruments: PSCs according to PLS: Elementary (Erythema, Papules, Pustules, Vesicles, Bubbles (>0.5 mm): 26 patients; Overgrowth of tissue: 14 patients; Ulcerative (Erosion, Healing ulcer, Mixed ulcer, Worsening ulcer): 70 patients. -PSCs according to SACS classification *: L1: 22 patients (20%); L2: 39 patients (35.5%); L3: 22 patients (20%); L4: 11 patients (10%); LX: 15 patients (14.5%) | - | - | - |
Taneja C, 2019, US, [3] | Retrospective study | Tot: 168 patients; M: 78 patients (46.4%); F: 90 patients (53.6%); Mean age: 63.9 years | Colostomy: 108 patients (64.3%); Ileostomy: 40 patients (23.8%) | N.A. | PSCs incidence: 36.3% | N.A. | N.A. | N.A. | PSCs within 90 days of ostomy surgery: 36.3% (ileostomy, 47.5%; colostomy, 36.1%); Mean time from surgery to first notation of a PSC: 26.4 days; Ileostomy group: 24.1 days; Colostomy groups: 27.2 days | Patients with PSCs were more likely to be readmitted to hospital by day 120 (55.7% vs. 35.5% for those without PSCs); Mean length of stay for PSCs patients readmitted to hospital: 11.0 days vs. 6.8 days for those without PSCs; Mean number of outpatient care visits: Colostomy: 7.4 (6.3%); Ileostomy: 5.7 (2.0%), Mean total PSCs healthcare cost over 120 days per patients: USD 58,329 vs. USD 50,298 for those without PSCs |
Nagano M, 2019, Japan, [25] | Retrospective study | Tot: 89 patients; M: 58 patients (65.2%); F: 31 patients (34.8%); Mean age: 65 years | Ileostomy: 52 patients (58.4%); Colostomy: 37 patients (41.6%) | Colorectal cancer | N.A. | MASD | N.A. | Ileostomies; Temporary stomas; Chemotherapy | 8 week after ostomy surgery: 51.9% of MASD | N.A. |
Voegeli D., 2020, UK, [37] | Multinational survey | Tot: 4235 patients; M: 55% F: 45% | Colostomy: 43%; Ileostomy: 38%; More than one: 2% | N.A. | PSCs self-reported incidence: 73.4% | Itching: 67%; Bleeding: 45%; Discoloration: 38%; Burning: 32%; Moisture from damage: 28%; Pain: 21%; Wounds:11%; Tissue overgrowth: 7% | N.A. | Higher risk of PSCs after ileostomy surgery: 1.9 higher than in those with colostomy; 1.5 times higher risk of PSCs in the first 2 years after ostomy surgery; Greater risk in women: 1.35 more than in men. | N.A. | N.A. |
Carbonell B.B, 2020, Switzerland, [26] | Retrospective study | Tot: 111 patients; M: 64 patients (58%); F: 47 patients (42%); Mean age: 67.61 ± 15 | Colostomy: 40 patients (36%); Ileostomy: 71 patients (64%) | Malignant disease: 72 patients (65%); Benign disease: 39 patients (35%) | PSCs rate: 73% | Mild complications: Hyperemic lesion: 6 patients (5%); Erosive lesion: 25 patients (23%); Suture Fissure: 9 patients (8%); Relevant complications: Ulcerative lesion: 6 patients (5%); Muco-cutaneous separation: 57 patients (51%); Abscess: 3 patients (3%); Retraction: 5 patients (5%); Necrosis: 2 patients (2%) | SACS classification | Predictors for persistence of peristomal complications at 30 postoperative days: ASA score III/IV; urgent surgery | Early peristomal complications are common, usually mild. They are most likely to persist beyond 30 days in patients operated as emergencies and with an ASA score of III-IV | N.A. |
Salvadalena G, 2020, US, [12] | Retrospective study | Tot: 73 patients; M: 44 patients; F: 29 patients; Mean age: 56.2 ± 14.2 years | Colostomy: 35 patients (48.0%); Ileostomy: 33 patients (45.2%) | Bowel cancer: 36 patients (49.3%); Bladder cancer: 4 patients (5.5%); Crohn’s disease: 4 patients (5.5%); Ulcerative colitis: 8 patients (11.0%); Diverticulitis: 11 patients (15.1%); Familial polyposis: 1 patients (1.4%); Intestinal obstruction and/or perforation: 5 patients (6.8%); Other: 10 patients (13.7%) | N.A. | Irritant dermatitis: 37 patients (50.7%); Maceration: 15 patients (20.5%); Mechanical trauma: 12 patients (16.4%); Folliculitis: 3 patients (4.1%); Pyoderma gangrenosum, fungal rash, skin infection: 1 patient (1.4%) | Severities were grouped into mild, moderate, and severe, using a range score (0–15). | Stoma duration and/or peristomal creases; Increased risk of PSCs for every 1-week increase in ostomy duration. | 64 days after undergoing ostomy surgery | N.A. |
Ayik C, 2020, Turkey, [27] | Retrospective study | Tot: 572 patients; M: 302 patients; F: 270 patients; Mean age: 59.15 ± 13.86 years | End colostomy: 253 patients (44.2%); Loop colostomy: 40 patients (7%); End ileostomy: 151 patients (26.4%); Loop ileostomy: 128 patients (22.4%) | N.A. | N.A. | Early PSCs: PICD: 181 patients (31.6%); - Late PSCs: PICD: 149 patients (26%) | N.A. | BMI > 24.9 kg/m2; Temporary ostomy; Ileostomy | Early period (<30 days after surgery): 56.5% of complications; -Late period (>30 days after surgery): 36.2% of complications | N.A. |
Singh N, 2021, India, [33] | Prospective study | Tot: 36 patients; M: 28 patients; F: 8 patients; Age < 30: 19 patients; Age > 30: 17 patients | End Ileostomy: 13 patients; Loop Ileostomy: 23 patients | N.A. | N.A. | Peristomal irritation: 33 patients (91.7 %); Skin escoriation: 24 patients (66.7 %) | N.A. | N.A. | Early period (<30 days after surgery) | N.A. |
Maeda S, 2021, Japan, [28] | Retrospective study | Tot: 185 patients; M: 131 patients (70.8%); F: 54 patients (29.2%); Mean age: 62 years (range: 27–83 years) | Loop Ileostomy: 185 patients (100%) | Rectal malignancies Adenocarcinoma: 174 patients (94.1%) | Skin disorders: 62 patients (33.5%) | N.A. | N.A. | Higher BMI (≥25.0 kg/m2); Lower ostomy height (<20 mm) | N.A. | Readmissions: 3 patients |
He D, 2021, China, [21] | Retrospective study | Tot: 491 patients; M: 217 patients (65.96%); F: 112 patients (34.04%); Age ≤ 60: 171 patients (51.98%); Age > 60: 158 patients (48.02%) | Ileostomy | Colorectal cancer | N.A. | Peristomal dermatitis: 85 patients (17.31%) | N.A. | Diabetes; Female gender | Within one month after ileostomy. | N.A. |
Fellows J, 2021, Multinational, [36] | Multinational survey | Tot: 5187 patients; M: 56%; F: 44%; More than 18 years of age. | Colostomy: 51%; Ileostomy: 33% | N.A. | PSCs rate: 88% | PSC with >1 or 1 symptoms/signs (e.g., pain, itching, burning): 78% | Self-report assessment: Peristomal skin with mild discoloration: 32%; Peristomal skin with medium discoloration: 16%; Peristomal skin with severe discoloration: 4% | N.A. | N.A. | N.A. |
Pittmann J, 2022, US, [35] | Web-based survey | Tot: 202 patients; M: 144 patients; F: 46 patients; Mean age: 54.91 ± 14.52 years | Ileostomy: 89 patients (45.41%); Colostomy: 50 patients (25.51%); Multiple stomies: 13 patients (6.63%) | Cancer: 81 patients (46.55%); Ulcerative colitis: 39 patients (22.41%); Crohn disease: 23 patients (13.22%); Diverticulitis: 7 patients (4.02%); Trauma: 2 patients (1.15%); Other: 22 patients (12.64%) | N.A. | Peristomal skin irritation: 78% (n =135/173) | N.A. | N.A. | N.A. | N.A. |
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Meisner, S.; Lehur, P.-A.; Moran, B.; Martins, L.; Jemec, G.B.E. Peristomal skin complications are common, expensive, and difficult to manage: A population based cost modeling study. PLoS ONE 2012, 7, e37813. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Persson, E.; Berndtsson, I.; Carlsson, E.; Hallén, A.-M.; Lindholm, E. Stoma-related complications and stoma size—A 2-year follow up. Color. Dis. 2010, 12, 971–976. [Google Scholar] [CrossRef] [PubMed]
- Taneja, C.; Netsch, D.; Rolstad, B.S.; Inglese, G.; Eaves, D.; Oster, G. Risk and Economic Burden of Peristomal Skin Complications Following Ostomy Surgery. J. Wound Ostomy Cont. Nurs. 2019, 46, 143–149. [Google Scholar] [CrossRef] [PubMed]
- Romão, M.; Figueira, D.; Galante, H.; Guerreiro, J.; Romano, S. Who are the ostomy patients and caregivers attending Portuguese community pharmacies? A cross-sectional study. BMC Health Serv. Res. 2020, 20, 914. [Google Scholar] [CrossRef] [PubMed]
- 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. 2019, 16, 433–441. [Google Scholar] [CrossRef]
- Ambe, P.C.; Kurz, N.R.; Nitschke, C.; Odeh, S.F.; Möslein, G.; Zirngibl, H. Intestinal ostomy: Classification, indications, ostomy care and complication management. Dtsch. Ärzteblatt Int. 2018, 115, 182–187. [Google Scholar] [CrossRef] [Green Version]
- Gálvez, A.M.; Sánchez, F.J.; Moreno, C.A.; Fernández, A.P.; García, R.B.; López, M.C.; Ramírez, M.B.; López, M.C.; Burrero, L.V.; Berja, P.J.; et al. Value-based healthcare in ostomies. Int. J. Environ. Res. Public Health 2020, 17, 5879. [Google Scholar] [CrossRef]
- Claessens, I.; Probert, R.; Tielemans, C.; Steen, A.; Nilsson, C.; Andersen, B.D.; Størling, Z.M. The ostomy life study: The everyday challenges faced by people living with a stoma in a snapshot. Gastrointest. Nurs. 2015, 13, 18–25. [Google Scholar] [CrossRef]
- Krishnamurty, D.; Blatnik, J.; Mutch, M. Stoma complications. Clin. Colon Rectal Surg. 2017, 30, 193–200. [Google Scholar] [CrossRef] [Green Version]
- Maglio, A.; Malvone, A.P.; Scaduto, V.; Brambilla, D.; Denti, F.C. The frequency of early stomal, peristomal and skin complications. Br. J. Nurs. 2021, 30, 1272–1276. [Google Scholar] [CrossRef]
- Husain, S.; Cataldo, T. Late stomal complications. Clin. Colon Rectal Surg. 2008, 21, 031–040. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Salvadalena, G.; Colwell, J.C.; Skountrianos, G.; Pittman, J. Lessons learned about peristomal skin complications: Secondary analysis of the ADVOCATE trial. J. Wound Ostomy Cont. Nurs. 2020, 47, 357–363. [Google Scholar] [CrossRef] [PubMed]
- Taneja, C.; Netsch, D.; Rolstad, B.S.; Inglese, G.; Lamerato, L.; Oster, G. Clinical and economic burden of peristomal skin complications in patients with recent ostomies. J. Wound Ostomy Cont. Nurs. 2017, 44, 350–357. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Steinhagen, E.; Colwell, J.; Cannon, L.M. Intestinal stomas—Postoperative stoma care and peristomal skin complications. Clin. Colon Rectal Surg. 2017, 30, 184–192. [Google Scholar] [CrossRef]
- Nybaek, H.; Jemec, G.; Jemec, G. Skin problems in stoma patients. J. Eur. Acad. Dermatol. Venereol. 2010, 24, 249–257. [Google Scholar] [CrossRef]
- Ustundag, H.; Gul, A.; Togluk, E. Assessment of peristomal skin complications in Turkish individuals with in intestinal stoma: A retrospective study. Int. J. Caring Sci. 2022, 15, 627–632. Available online: http://www.internationaljournalofcaringsciences.org/docs/64.pp_627_632-ustundag.pdf. (accessed on 3 October 2022).
- Nybaek, H.; Knudsen, D.B.; Laursen, T.N.; Karlsmark, T.; Jemec, G.B. Quality of life assessment among patients with peristomal skin disease. Eur. J. Gastroenterol. Hepatol. 2010, 22, 139–143. [Google Scholar] [CrossRef]
- Nichols, T.R.; Inglese, G.W. The burden of peristomal skin complications on an ostomy population as assessed by health utility and the physical component summary of the SF-36v2 ®. Value Health 2018, 21, 89–94. [Google Scholar] [CrossRef] [Green Version]
- Colwell, J.C.; Pittman, J.; Raizman, R.; Salvadalena, G. A randomized controlled trial determining variances in ostomy skin conditions and the economic impact (ADVOCATE trial). J. Wound Ostomy Cont. Nurs. 2018, 45, 37–42. [Google Scholar] [CrossRef] [Green Version]
- Page, M.J.; McKenzie, J.E.; Bossuyt, P.M.; Boutron, I.; Hoffmann, T.C.; Mulrow, C.D.; Shamseer, L.; Tetzlaff, J.M.; Akl, E.A.; Brennan, S.E.; et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021, 372, n71. [Google Scholar] [CrossRef]
- He, D.; Liang, W.; Yao, Q.; Zhao, J.; Liu, R.; Chen, G.; Wang, H.; Ye, X.; Huang, R. The effect of stoma education class on peristomal dermatitis in colorectal cancer patients with defunctioning ileostomy—A retrospective study of 491 patients. Transl. Cancer Res. 2021, 10, 581–588. [Google Scholar] [CrossRef] [PubMed]
- Baykara, Z.G.; Demir, S.G.; Karadag, A.; Harputlu, D.; Kahraman, A.; Karadag, S.; Hin, A.O.; Togluk, E.; Altinsoy, M.; Erdem, S.; et al. A multicenter, retrospective study to evaluate the effect of preoperative stoma site marking on stomal and peristomal complications. Ostomy Wound Manag. 2014, 60, 16–26. [Google Scholar]
- Sarkut, P.; Dundar, H.Z.; Tirnova, I.; Ozturk, E.; Yilmazlar, T. Is stoma care effective in terms of morbidity in complicated ileostomies? Int. J. Gen. Med. 2015, 8, 243–246. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Cressey, B.D.; Belum, V.R.; Scheinman, P.; Silvestri, D.; McEntee, N.; Livingston, V.; Lacouture, M.E.; Zippin, J.H. Stoma care products represent a common and previously underreported source of peristomal contact dermatitis. Contact Dermat. 2017, 76, 27–33. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Nagano, M.; Ogata, Y.; Ikeda, M.; Tsukada, K.; Tokunaga, K.; Iida, S. Peristomal moisture-associated skin damage and independence in pouching system changes in persons with new fecal ostomies. J. Wound Ostomy Cont. Nurs. 2019, 46, 137–142. [Google Scholar] [CrossRef] [PubMed]
- Carbonell, B.B.; Treter, C.; Staccini, G.; MajnoHurst, P.; Christoforidis, D. Early peristomal complications: Detailed analysis, classification and predictive risk factors. Ann Ital Chir. 2020, 91, 69–73. [Google Scholar] [PubMed]
- Ayik, C.; Özden, D.; Cenan, D. Ostomy complications, risk factors, and applied nursing care: A retrospective, descriptive study. Wound Manag. Prev. 2020, 66, 20–30. [Google Scholar] [CrossRef]
- Maeda, S.; Ouchi, A.; Komori, K.; Kinoshita, T.; Oshiro, T.; Ito, S.; Abe, T.; Shimizu, Y. Risk factors for peristomal skin disorders associated with temporary ileostomy construction. Surg. Today 2021, 51, 1152–1157. [Google Scholar] [CrossRef]
- Salvadalena, G.D. The incidence of stoma and peristomal complications during the first 3 months after ostomy creation. J. Wound Ostomy Cont. Nurs. 2013, 40, 400–406. [Google Scholar] [CrossRef]
- Lindholm, E.; Persson, E.; Carlsson, E.; Hallén, A.-M.; Fingren, J.; Berndtsson, I. Ostomy-related complications after emergent abdominal surgery: A 2-year follow-up study. J. Wound Ostomy Cont. Nurs. 2013, 40, 603–610. [Google Scholar] [CrossRef]
- Carlsson, E.; Fingren, J.; Hallén, A.-M.; Petersén, C.; Lindholm, E. The prevalence of ostomy-related complications 1 year after ostomy surgery: A prospective, descriptive, clinical study. Ostomy Wound Manag. 2016, 62, 34–48. [Google Scholar]
- Harputlu, D.; Özsoy, S.A. A prospective, experimental study to assess the effectiveness of home care nursing on the healing of peristomal skin complications and quality of life. Ostomy Wound Manag. 2018, 64, 18–30. [Google Scholar] [CrossRef]
- Singh, N.; Bhatia, P.K.; Goyal, K.S.; Pundeer, S.; Kallem, S.R.; Gandhi, H.; Devi, D. Prospective study of clinical profile and early complications of ileostomy. J. Evol. Med. Dent. Sci. 2021, 10, 694–700. [Google Scholar] [CrossRef]
- Nichols, T. Health utility, social interactivity, and peristomal skin status: A cross-sectional study. J. Wound Ostomy Cont. Nurs. 2018, 45, 438–443. [Google Scholar] [CrossRef] [PubMed]
- Pittman, J.; Colwell, J.; Mulekar, M.S. Ostomy complications and quality of life of ostomy support belt/garment wearers: A web-based survey. J. Wound Ostomy Cont. Nurs. 2022, 49, 60–68. [Google Scholar] [CrossRef]
- Fellows, J.; Voegeli, D.; Håkan-Bloch, J.; Herschend, N.O.; Størling, Z. Multinational survey on living with an ostomy: Prevalence and impact of peristomal skin complications. Br. J. Nurs. 2021, 30, S22–S30. [Google Scholar] [CrossRef]
- Voegeli, D.; Karlsmark, T.; Eddes, E.H.; Hansen, H.D.; Zeeberg, R.; Håkan-Bloch, J.; Hedegaard, C.J. Factors influencing the incidence of peristomal skin complications: Evidence from a multinational survey on living with a stoma. Gastrointest. Nurs. 2020, 18, S31–S38. [Google Scholar] [CrossRef]
- Malik, T.; Lee, M.J.; Harikrishnan, A.B. The incidence of stoma related morbidity—A systematic review of randomised controlled trials. Ann. R Coll. Surg. Engl. 2018, 100, 501–508. [Google Scholar] [CrossRef]
- Bloemen, A.; Aarts, F.; Bouvy, N.; Nijhuis, P. Evaluation of a new elastic ostomy appliance to decrease skin complications: Results of a pilot study. Wound Manag. Prev. 2020, 66, 30–36. [Google Scholar] [CrossRef]
- Martins, L.; Tavernelli, K.; Sansom, W.; Dahl, K.; Claessens, I.; Porrett, T.; Andersen, B.D. Strategies to reduce treatment costs of peristomal skin complications. Br. J. Nurs. 2012, 21, 1312–1315. [Google Scholar] [CrossRef]
- Burch, J. Care of patients with peristomal skin complications. Nurs. Stand. 2014, 28, 51–57. [Google Scholar] [CrossRef] [PubMed]
- Szewczyk, M.T.; Majewska, G.; Cabral, M.V.; Hölzel-Piontek, K. The effects of using a moldable skin barrier on peristomal skin condition in persons with an ostomy: Results of a prospective, observational, multinational study. Ostomy Wound Manag. 2014, 60, 16–26. [Google Scholar]
- Colwell, J.C.; McNichol, L.; Boarini, J. North America wound, ostomy, and continence and enterostomal therapy nurses current ostomy care practice related to peristomal skin issues. J. Wound Ostomy Cont. Nurs. 2017, 44, 257–261. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Salomé, G.M.; de Almeida, S.A.; Mendes, B.; de Carvalho, M.R.F.; Junior, M.R.M. Assessment of subjective well-being and quality of life in patients with intestinal stoma. J. Coloproctol. 2015, 35, 168–174. [Google Scholar] [CrossRef]
- Ratliff, C.R.; Goldberg, M.; Jaszarowski, K.; McNichol, L.; Pittman, J.; Gray, M. Peristomal Skin Health: A WOCN Society Consensus Conference. J. Wound Ostomy Cont. Nurs. 2021, 48, 219–231. [Google Scholar] [CrossRef] [PubMed]
- Foà, C.; Bisi, E.; Calcagni, A.; Goldoni, A.; Moscatelli, M.P.; Pellicani, V.; Uccelli, S.; Sarli, L.; Artioli, G. Infectious risk in ostomy patient: The role of nursing competence. Acta Bio Medica Atenei Parm. 2019, 90, 53. [Google Scholar]
- Morss-Walton, P.C.; Yi, J.Z.; Gunning, M.; McGee, J.S. Ostomy 101 for dermatologists: Managing peristomal skin diseases. Dermatol. Ther. 2021, 34, e15069. [Google Scholar] [CrossRef]
- Murken, D.R.; Bleier, J.I.S. Ostomy-related complications. Clin. Colon Rectal Surg. 2019, 32, 176–182. [Google Scholar] [CrossRef]
- Jonkers, H.A.F.; Draaisma, W.A.; Roskott, A.M.; van Overbeeke, A.J.; Broeders, I.A.M.J.; Consten, E.C.J. Early complications after stoma formation: A prospective cohort study in 100 patients with 1-year follow-up. Int. J. Color. Dis. 2012, 27, 1095–1099. [Google Scholar] [CrossRef]
- LeBlanc, K.; Whiteley, I.; McNichol, L.; Salvadalena, G.; Gray, M. Peristomal medical adhesive-related skin injury: Results of an international consensus meeting. J. Wound Ostomy Cont. Nurs. 2019, 46, 125–136. [Google Scholar] [CrossRef]
- White, P.; Evans, M. Clinical governance for ostomates at risk of peristomal skin complications. Br. J. Nurs. 2019, 28, S24–S32. [Google Scholar] [CrossRef] [PubMed]
- European Commission. Expert panel on Effective Ways of Investing in Health (EXPH). Defining Value in “Value-Based Healthcare”. 2019. Available online: https://health.ec.europa.eu/system/files/2019-11/024_defining-value-vbhc_en_0.pdf (accessed on 24 October 2022).
- Brown, P.; Zhou, Y.; RELISH Consortium. Large expert-curated database for benchmarking document similarity detection in biomedical literature search. Database 2019, 2019, baz085. [Google Scholar] [CrossRef] [PubMed]
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
D’Ambrosio, F.; Pappalardo, C.; Scardigno, A.; Maida, A.; Ricciardi, R.; Calabrò, G.E. Peristomal Skin Complications in Ileostomy and Colostomy Patients: What We Need to Know from a Public Health Perspective. Int. J. Environ. Res. Public Health 2023, 20, 79. https://doi.org/10.3390/ijerph20010079
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. International Journal of Environmental Research and Public Health. 2023; 20(1):79. https://doi.org/10.3390/ijerph20010079
Chicago/Turabian StyleD’Ambrosio, Floriana, Ciro Pappalardo, Anna Scardigno, Ada Maida, Roberto Ricciardi, and Giovanna Elisa Calabrò. 2023. "Peristomal Skin Complications in Ileostomy and Colostomy Patients: What We Need to Know from a Public Health Perspective" International Journal of Environmental Research and Public Health 20, no. 1: 79. https://doi.org/10.3390/ijerph20010079