The Incidence of Stoma and Peristomal Complications During the First Three Months After Stoma Creation

Stoma and peristomal complications comprise a variety of conditions that vary in frequency, severity, and importance to individuals with incontinent stomas. Differences in study methodology and samples, plus the lack of precise measurement of complications, have all contributed to wide variability in reported prevalence and incidence rates.¹

This longitudinal, descriptive, repeated measure study was designed to describe the incidence of physiologic and anatomic problems of the stoma and peristomal skin, and to examine factors that may be related to these complications. Forty-three adults with stomas from two university teaching hospitals in a major Midwestern city participated. Subjects were evaluated, using clear definitions and reliable measures, two or more times for the presence of complications during the first three months after stoma creation. Complications were categorized using the ostomy forum observation index, described in a prior study.²

Six participants developed one or more stoma complications, all of which occurred 20 or more days after surgery. Peristomal skin complications developed in 27 participants, comprising 62.8% of the sample. The onset of peristomal skin complications occurred most frequently during the 21–40 day time period. The most common skin conditions at nearly all time intervals were categorized as irritation and infection. Of the 18 participants observed 70 days or longer, 61% experienced erythematous, irritated, infected, eroded, or macerated peristomal skin. Proportional hazards regression models were used to determine whether age, stoma type, gender, medications, or reason for surgery predicted the occurrence of stoma complications or skin complications. None of the variables tested were found to be significant for stoma complications and few predictors were found for individual peristomal complications.

These results support the need for outpatient follow-up care for individuals with stomas and highlight the need for investigation into new methods of preventing peristomal skin complications.