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Introduction: Peristomal skin is at risk for multiple skin disorders. By utilizing a standard peristomal skin assessment tool, clinicians and WOCNs can interact when reporting and monitoring these complications. In addition, an evaluation of the topography, extent and location of these skin disorders may allow optimal management of peristomal skin integrity and further assist the surgeon with ideal stoma placement. We sought to evaluate and categorize all stoma related skin complications in a prospective manner.
Methods: A prospective, ongoing observational study was conducted in which surgical patients with an ileostomy, a colostomy or urostomy were assessed post-operatively and on a regular basis thereafter as determined by the patient or home care nurse. The Italian skin disorder classification tool [Bosio et al, 2007] was utilized to document the type of lesion and location of skin breakdown beneath the stoma wafer by the WOCN or Nurse Practitioner. The data was analyzed for commonalities as related to lesion type, frequency and occurrence with respect to specific location.
Results: Over the most recent 9 month study period, 395 patients with surgically placed stomas received care by a WOCN. There were 209 ileostomies, 105 colostomies and 91
urostomies. Of these, skin complications were noted in 36% of ileostomies, 24% of colostomies, and 20% of urostomies. The majority of lesions noted were categorized as hyperemic or erosive (L1 or L2). When considering only ileostomy lesions, most (60%) were found to involve the inferior peristomal skin quadrants.
Conclusions: By utilizing a peristomal skin disorder tool, the prevalence of stoma related skin complications can be categorized. This data suggests that ileostomies are associated with a higher incidence of skin complications; and most are found in the inferior quadrants. WOCNs, nursing staff and surgeons should consider these findings when marking or fashioning a stoma.
Methods: A prospective, ongoing observational study was conducted in which surgical patients with an ileostomy, a colostomy or urostomy were assessed post-operatively and on a regular basis thereafter as determined by the patient or home care nurse. The Italian skin disorder classification tool [Bosio et al, 2007] was utilized to document the type of lesion and location of skin breakdown beneath the stoma wafer by the WOCN or Nurse Practitioner. The data was analyzed for commonalities as related to lesion type, frequency and occurrence with respect to specific location.
Results: Over the most recent 9 month study period, 395 patients with surgically placed stomas received care by a WOCN. There were 209 ileostomies, 105 colostomies and 91
urostomies. Of these, skin complications were noted in 36% of ileostomies, 24% of colostomies, and 20% of urostomies. The majority of lesions noted were categorized as hyperemic or erosive (L1 or L2). When considering only ileostomy lesions, most (60%) were found to involve the inferior peristomal skin quadrants.
Conclusions: By utilizing a peristomal skin disorder tool, the prevalence of stoma related skin complications can be categorized. This data suggests that ileostomies are associated with a higher incidence of skin complications; and most are found in the inferior quadrants. WOCNs, nursing staff and surgeons should consider these findings when marking or fashioning a stoma.