Risk factors living with an ostomy from rectal cancer based on independence in changing ostomy appliances and peristomal irritant dermatitis

Midori Nagano, R.N., C.N.(WOC), Ph.D., Nursing Adomistration, The Jikei University School of Nursing, Tokyo, Japan, Yasuko Ogata, R.N., P.H.N., M.M., Ph.D., Department of Gerontological Nursing and Care System Development, Tokyo Medical and Dental University, Tokyo, Japan, Masaomi Ikeda, R.D.T., B.Sc., Ph.D., Oral Prosthetic Engineering, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan, Kunio Tsukada, M.D., Ph.D., Takaoka Ekinan Clinic, Director, Takaoka-si, Japan, Keiko Tokunaga, BSN, RN, ET, Miyagi University, Professor, Kurokawa-gun Miyagi-ken, Japan and Satoshi Iida, M.D,, Ph.D., Colorectal Surgery, Ohta General Hospital Foundation Nishinouchi Hospital, Fukushima, Japan

The number of ostomates requiring support for independence in changing their ostomy appliances is growing as a result of the increasing incidence of colon cancer, aging society, and the shortening of hospitalizations. Ostomates are more inclined to have peristomal irritant dermatitis from their ileostomy due to the progress of treatment and expansion of chemotherapy. This study described characteristics of living with an ostomy based on the factors of independence in changing appliances and existence of peristomal irritant dermatitis.


This retrospective survey was conducted from patients’ outpatient and inpatient treatment records of rectal cancer ostomy surgery and who had visited a stoma clinic between 2008 and 2014.


Records from a total of 44 colostomates and 57 ileostomates were examined. Overall, 33.7% of ostomates required assistance with changing ostomy appliances at 8 weeks after surgery, and 29.3% required assistance at 16 weeks after surgery. Significantly more ostomates over 65 required assistance than those under 65 years old (p<0.01) and also for diabetic patients (p<0.01). In total, 36% of ostomates had peristomal irritant dermatitis. The incidence of peristomal irritant dermatitis was higher for those with ileostomies than colostomies (odds ratio, 3.101), and was also higher among patients receiving chemotherapy (odds ratio, 2.483).


Advance age and diabetes reduced patients’ ability in changing ostomy appliances. Ileostomy and chemotherapy disposed patients to peristomal irritant dermatitis. Most rectal cancer patients with a stoma were at risk for both or either. Stoma clinics must strengthened consultation correspondence and resource functions for local medical welfare professionals. In particular, this support should include preoperative assessment and long-term care.