Stoma-related complications in the Obese Population

Obesity, defined by the National Institutes of Health (NIH) as a body mass index (BMI) >30, has been recognized as a national health threat and a major health problem. It is estimated that 40% of the population will be obese by the end of this decade. Obesity is a costly condition that reduces quality of life and increases the risk for many serious chronic diseases such as type II diabetes, coronary artery disease, hypertension, cancer, and respiratory disease.  These risk factors also influence with intra- and post-operative outcomes in stoma formation and management.  Stoma related complications have been reported as high as 36%, and obesity is one of the risk factors for stoma failure.

Obese patients undergoing a surgical procedure that results in a fecal or urinary diversion require the advanced skills of a multidisciplinary healthcare team.  Patients who are obese carry a higher risk of wound and cardiopulmonary complications and often present a serious challenge in stoma creation and management. Obese patients are at high risk of stomal complications. The goal of this poster presentation is to review the knowledge and skills necessary to manage stoma related complications in the obese patient population. Topics include stoma site selection, management and assessment of peristomal herniation, necrosis, retraction, mucocutaneous separation, and stenosis.