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Article

Outcomes of a Risk-Stratified Protocol for Preventing Peristomal Skin Complications in Patients with an Ostomy: A Cohort Study

by
Francesco Carlo Denti
1,
Eliana Guerra
2,
Francesca Caroppo
3,4,
Pietro Abruzzese
5,
Fabrizio Alessi
6,
Filippo Barone
7,
Pasqualina Bernardino
8,
Massimiliano Bergamini
9,
Maria Cristina Bernardo
10,
Gloria Bosio
11,
Paula Carp
12,
Manuela Cecconello
13,
Annalinda Cerchier
14,
Francesca Croci
15,
Rita Detti
16,
Mina Milenova Dimitrova
17,
Cristina Di Pasquale
18,
Maria Rosaria D'Ippolito
19,
Simona Ditta
16,
Erica Ducci
20,
Anna Belloni Fortina
4,
Stefano Frascarelli
21,
Marianna Galante
22,
Rita Guarino
23,
Nicola Leggio
1,
Elisabetta Livio
24,
Alessandra Marchetti
25,
Francesca Marelli
26,
Rita Mastropaolo
27,
Viviana Melis
28,
Nicola Palmiero
19,
Arianna Panarelli
29,
Anna Lea Pascali
30,
Francesco Pizzarelli
31,
Laura Precisi
32,
Cinzia Rastello
33,
Silvia Regaglia
34,
Rossana Elvira Rinaldi
35,
Nadia Rumbolo
36,
Claudio Sansone
37,
Angela Santelli
38,
Giovanni Sarritzu
39,
Stefano Sfondrini
40,
Sara Stanzani
5,
Mattia Stella
41,
Margherita Walterova
42 and
Rosario Caruso
43,44,*add Show full author list remove Hide full author list
1
Stomacare Service, IRCCS San Raffaele Institute, 20132 Milan, Italy
2
Enterostomal Rehabilitation Clinic, ASST Spedali Civili Brescia, 25123 Brescia, Italy
3
Dermatology Unit, Department of Medicine DIMED, University of Padua, 35131 Padua, Italy
4
Department of Womens’ and Children’s Health (SDB), University of Padova, 35131 Padua, Italy
5
Stomacare Service, Ospedale Bellaria Carlo Alberto Pizzardi, 40139 Bologna, Italy
6
Stomacare Service, Ospedale di Legnano, ASST Ovest Milanese, 20025 Legnano, Italy
7
Stomacare Service, Ospedale Generale Regionale Francesco Miulli, 70021 Acquaviva delle Fonti, Italy
8
Stomacare Service, A.O.O.R Villa Sofia-V. Cervello, 90146 Palermo, Italy
9
Stomacare Service, Presidio Ospedaliero Universitario “Santa Maria della Misericordia”, 45100 Rovigo, Italy
10
Stomacare Service, Presidio Ospedaliero di Ivrea, ASL Torino 4, 10015 Ivrea, Italy
11
Stomacare Service, Ospedale di Rivoli, 10098 Rivoli, Italy
12
Stomacare Service, Presidio Ospedaliero Martini, 10141 Torino, Italy
13
Stomacare Service, Ospedale di Feltre, 32032 Feltre, Italy
14
Stomacare Service, Ospedale di San Donà di Piave, 30027 San Donà di Piave, Italy
15
Stomacare Service, Ospedale “Val Vibrata” di Sant’Omero, ASL Teramo, 64027 Teramo, Italy
16
Stomacare Service, Azienda Ospedaliero, Universitaria Senese, 53100 Siena, Italy
17
Stoma Therapy Service, P. Pederzoli Hospital, 37019 Peschiera del Garda, Italy
18
Stomal Therapy Outpatient Service, European Institute of Oncology IRCCS, 20141 Milan, Italy
19
Stomacare Service, Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli, 80131 Napoli, Italy
20
Stomacare Service, Ospedale Luigi Sacco, 20157 Milan, Italy
21
Stomacare Service, USL Umbria 1, 06127 Perugia, Italy
22
Stomacare Service, Ospedale Santa Chiara, 38123 Trento, Italy
23
Stomacare Service, IRCCS Fondazione G. Pascale di Napoli, 80131 Napoli, Italy
24
Stomacare Service, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
25
Stomacare Service, Clinica Ospedaliero, Universitaria Policlinico Umberto I, 00161 Rome, Italy
26
Stomacare Service, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
27
Stomacare Service, Ospedale di Bolzano, 39100 Bolzano, Italy
28
Stomacare Service, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
29
Stomacare Service, Policlinico di Bari Ospedale “Giovanni XXIII”, 70124 Bari, Italy
30
Stomacare Service, Asl Lecce, 73100 Lecce, Italy
31
Stomacare Service, Azienda Ospedaliera di Padova, 35131 Padua, Italy
32
Stomacare Service, Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy
33
Stomacare Service, Azienda Ospedaliera Universitaria San Luigi Gonzaga, 10043 Orbassano, Italy
34
Stomacare Service, Ospedale Civile Santissima Annunziata, 07100 Sassari, Italy
35
Stomacare Service, Ospedale Pesenti Fenaroli, 24022 Alzano Lombardo, Italy
36
Stomacare Service, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
37
Stomacare Service, Azienda Ospedaliera San Giovanni Addolorata, 00184 Rome, Italy
38
Stomacare Service, Ospedale Pio XI, 20832 Desio, Italy
39
Stomacare Service, Policlinico Universitario Monserrato “Duilio Casula”, 09042 Monserrato, Italy
40
Stomacare Service, Ospedale S. Anna, ASST Lariana, 22042 Como, Italy
41
Stomacare Service, Ospedale Santa Maria delle Croci, 48121 Ravenna, Italy
42
Stomacare Service, IRCCS Saverio De Bellis, 70013 Castellana Grotte, Italy
43
Health Professions Research and Development Unit, IRCCS Policlinico San Donato, 20097 San Donato Milanese, Italy
44
Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy
 
add Show full affiliation list
 
remove Hide full affiliation list
*
Author to whom correspondence should be addressed.
Nurs. Rep. 2025, 15(5), 179; https://doi.org/10.3390/nursrep15050179
Submission received: 10 February 2025 / Revised: 11 May 2025 / Accepted: 16 May 2025 / Published: 20 May 2025
(This article belongs to the Special Issue Research Innovations in Skin and Wound Care)
Versions Notes

Abstract

Background/Objectives: Peristomal skin complications (PSCs) are common among patients with ostomies, significantly impacting quality of life and increasing healthcare utilization. This study aimed to evaluate the effects of the Dermamecum protocol, a risk-stratified educational intervention, on the prevention of PSCs, self-care improvements, health-related quality of life (HRQoL), and patient satisfaction over a 90-day follow-up period. Methods: This prospective cohort study included 305 patients stratified into three risk-based groups (green, yellow, and red paths) according to the Dermamecum protocol. Primary outcomes included PSC rates at 30, 60, and 90 days. Secondary outcomes included self-care scores, HRQoL, and patient satisfaction. Comparative analyses and trend assessments were performed across groups and time points. Temporal trends in PSCs were analyzed using Poisson regression. Results: Early PSC rates were 8.5% at 30 days, with late complications at 7.9% and 6.2% at 60 and 90 days, respectively. No significant differences in PSC rates were observed between paths. Self-care scores improved over time, with stability across groups and domains. HRQoL remained stable, with minor fluctuations in physical and mental components. Patient satisfaction was high across all paths. Poisson regression identified significant temporal trends in PSC rates, with higher risks at 30, 60, and 90 days compared to baseline. Age, BMI, and path assignment (lower risk for the green path) were significant predictors of PSCs. Conclusions: The Dermamecum protocol effectively maintained low PSC rates, supported self-care, and sustained HRQoL and patient satisfaction. These findings highlight the value of risk-stratified, patient-centered interventions in ostomy care. Further studies are needed to validate these results and explore long-term outcomes.
Keywords: peristomal skin complications; ostomy care; risk-stratified education; self-care; health-related quality of life; patient satisfaction; Poisson regression; stoma care outcomes; risk management peristomal skin complications; ostomy care; risk-stratified education; self-care; health-related quality of life; patient satisfaction; Poisson regression; stoma care outcomes; risk management

Share and Cite

MDPI and ACS Style

Denti, F.C.; Guerra, E.; Caroppo, F.; Abruzzese, P.; Alessi, F.; Barone, F.; Bernardino, P.; Bergamini, M.; Bernardo, M.C.; Bosio, G.; et al. Outcomes of a Risk-Stratified Protocol for Preventing Peristomal Skin Complications in Patients with an Ostomy: A Cohort Study. Nurs. Rep. 2025, 15, 179. https://doi.org/10.3390/nursrep15050179

AMA Style

Denti FC, Guerra E, Caroppo F, Abruzzese P, Alessi F, Barone F, Bernardino P, Bergamini M, Bernardo MC, Bosio G, et al. Outcomes of a Risk-Stratified Protocol for Preventing Peristomal Skin Complications in Patients with an Ostomy: A Cohort Study. Nursing Reports. 2025; 15(5):179. https://doi.org/10.3390/nursrep15050179

Chicago/Turabian Style

Denti, Francesco Carlo, Eliana Guerra, Francesca Caroppo, Pietro Abruzzese, Fabrizio Alessi, Filippo Barone, Pasqualina Bernardino, Massimiliano Bergamini, Maria Cristina Bernardo, Gloria Bosio, and et al. 2025. "Outcomes of a Risk-Stratified Protocol for Preventing Peristomal Skin Complications in Patients with an Ostomy: A Cohort Study" Nursing Reports 15, no. 5: 179. https://doi.org/10.3390/nursrep15050179

APA Style

Denti, F. C., Guerra, E., Caroppo, F., Abruzzese, P., Alessi, F., Barone, F., Bernardino, P., Bergamini, M., Bernardo, M. C., Bosio, G., Carp, P., Cecconello, M., Cerchier, A., Croci, F., Detti, R., Dimitrova, M. M., Di Pasquale, C., D'Ippolito, M. R., Ditta, S., ... Caruso, R. (2025). Outcomes of a Risk-Stratified Protocol for Preventing Peristomal Skin Complications in Patients with an Ostomy: A Cohort Study. Nursing Reports, 15(5), 179. https://doi.org/10.3390/nursrep15050179

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