Ostomy Complications in a Long Term Acute Care (LTAC) Facility

Aim of Study:  The objective of this study is to determine prevalence of stomal or peristomal ostomy complications among long term acute care (LTAC) patients. 

Background and Significance:  Literature reports peristomal skin complication rates of 10-70%¹.  Ratliff reports ileostomy as having the highest rate of complications.²  Comparison between reports is difficult as different authors report different complications.

Study Design:  Data was collected retrospectively from documentation by the Wound, Ostomy, Continence Clinical Nurse Specialist (WOC CNS).

Study Population:  Eighty-nine adult patients with ninety-two ostomies were seen by the WOC CNS over a period of 25 months. 

Study Results:  There were fifty patients with colostomies, thirty-four patients with ileostomies, seven patients with ileo-conduits and one patient with a jejunostomy. 45 of 92 stomas (49%) had complications. 46% of colostomies had complications. The most frequent colostomy complication was irritant dermatitis, followed by mucocutaneous separation, retraction, and hernia.  44% of ileostomies had complications.  The most frequent ileostomy complication was irritant dermatitis, followed by mucocutaneous separation.  86% of ileo-conduits had complications.  The most frequent ileo-conduit complication was irritant dermatitis, followed by retraction and candidiasis.  The one jejunostomy experienced both retraction and irritant dermatitis. 

Seventy stomas were considered new (less than six months) and twenty-two were considered old (more than six months).  50% of new stomas had complications, irritant dermatitis being the most frequent (occurring with 60% of the new stomas with complications).  45% of old stomas were associated with complications, irritant dermatitis being the most frequent (occurring with 70% of the old stomas with complications).