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Ostomy-related complications after emergent abdominal surgery a 2-year follow-up study

Lindholm, Elisabet; Persson, Eva LU ; Carlsson, Eva; Hallén, Anne Marie; Fingren, Jeanette and Berndtsson, Ina (2013) In Journal of Wound, Ostomy and Continence Nursing 40(6). p.603-610
Abstract

PURPOSE: The aim of this study was to prospectively evaluate ostomy-related complications and describe ostomy configuration in patients undergoing acute abdominal surgery. SUBJECTS AND SETTING: The study sample comprised 144 patients with a median age of 67 years (IOR: 53.5-78 years) who underwent an intestinal ostomy as part of an acute abdominal surgical procedure. The research setting was the surgical and gynecological clinics at the Sahlgrenska University Hospital in Gothenburg, Sweden. METHODS: Ostomy configuration, diameter, height, and the presence of stomal and peristomal complications were assessed by a WOC nurse 1 to 2 times while in hospital, once at the ostomy outpatient clinic 2 weeks after discharge, and at 3, 6, 12, and... (More)

PURPOSE: The aim of this study was to prospectively evaluate ostomy-related complications and describe ostomy configuration in patients undergoing acute abdominal surgery. SUBJECTS AND SETTING: The study sample comprised 144 patients with a median age of 67 years (IOR: 53.5-78 years) who underwent an intestinal ostomy as part of an acute abdominal surgical procedure. The research setting was the surgical and gynecological clinics at the Sahlgrenska University Hospital in Gothenburg, Sweden. METHODS: Ostomy configuration, diameter, height, and the presence of stomal and peristomal complications were assessed by a WOC nurse 1 to 2 times while in hospital, once at the ostomy outpatient clinic 2 weeks after discharge, and at 3, 6, 12, and 24 months following ostomy creation. RESULTS: The types of ostomies evaluated were end colos-tomy (58%), end ileostomy (18%), loop ileostomy (17%), and loop colostomy (7%). Most stomal or peristomal complications occurred within 1 year after surgery (31 of 57; 54.4%). Necrosis, separation, and stenosis were most common in patients with an end colostomy. Peristomal skin complications occurred in 45% of subjects during the first 6 months after surgery. The ostomy's diameter decreased significantly during the hospital course and over the first 2 weeks following hospital discharge in patients with end colostomy (P <.0001), end ileostomy (P <.0081), loop ileostomy (P =.008), and loop colostomy (ns). Patients with a low ostomy had peristomal skin problems ranging between 21% and 57% over this time period. The frequency of using a pouching system that incorporated convexity was highest in the case of loop ileostomy, used in 67% at 6 months. CONCLUSION: During the first 2 weeks after discharge, the physical configuration of the ostomy evolves and the pouching system must be frequently adjusted by a WOC nurse. Stomal and peristomal complications are prevalent during the first 2 postoperative years and especially during the first 6 months.

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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute surgery, Colostomy, Complications, Enterostomal therapist, Ileostomy, Loop ileostomy, Ostomy, Ostomy configuration, Transverse colostomy
in
Journal of Wound, Ostomy and Continence Nursing
volume
40
issue
6
pages
8 pages
publisher
Lippincott Williams and Wilkins
external identifiers
  • scopus:84888009028
ISSN
1071-5754
DOI
10.1097/WON.0b013e3182a9a7d9
language
English
LU publication?
no
id
6471d114-c472-448e-bbb5-88936fca972e
date added to LUP
2018-02-09 13:35:51
date last changed
2018-07-08 04:29:57
@article{6471d114-c472-448e-bbb5-88936fca972e,
  abstract     = {<p>PURPOSE: The aim of this study was to prospectively evaluate ostomy-related complications and describe ostomy configuration in patients undergoing acute abdominal surgery. SUBJECTS AND SETTING: The study sample comprised 144 patients with a median age of 67 years (IOR: 53.5-78 years) who underwent an intestinal ostomy as part of an acute abdominal surgical procedure. The research setting was the surgical and gynecological clinics at the Sahlgrenska University Hospital in Gothenburg, Sweden. METHODS: Ostomy configuration, diameter, height, and the presence of stomal and peristomal complications were assessed by a WOC nurse 1 to 2 times while in hospital, once at the ostomy outpatient clinic 2 weeks after discharge, and at 3, 6, 12, and 24 months following ostomy creation. RESULTS: The types of ostomies evaluated were end colos-tomy (58%), end ileostomy (18%), loop ileostomy (17%), and loop colostomy (7%). Most stomal or peristomal complications occurred within 1 year after surgery (31 of 57; 54.4%). Necrosis, separation, and stenosis were most common in patients with an end colostomy. Peristomal skin complications occurred in 45% of subjects during the first 6 months after surgery. The ostomy's diameter decreased significantly during the hospital course and over the first 2 weeks following hospital discharge in patients with end colostomy (P &lt;.0001), end ileostomy (P &lt;.0081), loop ileostomy (P =.008), and loop colostomy (ns). Patients with a low ostomy had peristomal skin problems ranging between 21% and 57% over this time period. The frequency of using a pouching system that incorporated convexity was highest in the case of loop ileostomy, used in 67% at 6 months. CONCLUSION: During the first 2 weeks after discharge, the physical configuration of the ostomy evolves and the pouching system must be frequently adjusted by a WOC nurse. Stomal and peristomal complications are prevalent during the first 2 postoperative years and especially during the first 6 months.</p>},
  author       = {Lindholm, Elisabet and Persson, Eva and Carlsson, Eva and Hallén, Anne Marie and Fingren, Jeanette and Berndtsson, Ina},
  issn         = {1071-5754},
  keyword      = {Acute surgery,Colostomy,Complications,Enterostomal therapist,Ileostomy,Loop ileostomy,Ostomy,Ostomy configuration,Transverse colostomy},
  language     = {eng},
  number       = {6},
  pages        = {603--610},
  publisher    = {Lippincott Williams and Wilkins},
  series       = {Journal of Wound, Ostomy and Continence Nursing},
  title        = {Ostomy-related complications after emergent abdominal surgery a 2-year follow-up study},
  url          = {http://dx.doi.org/10.1097/WON.0b013e3182a9a7d9},
  volume       = {40},
  year         = {2013},
}