Evaluating the Effectiveness and Safety of Fecal Management Systems among Severely Ill Patients Suffering from Fecal Incontinence: A Retrospective Cohort Study

Abstract

Background. Few large-sample studies have examined the use of fecal management systems (FMSs) in intensive care units (ICUs) or evaluated the associated complications. This study aims to assess the effectiveness and safety of FMS for stool diversion in ICU patients with fecal incontinence (FI). Methods. We enrolled 381 FI patients, assigning them to either an FMS group (n = 134), which used a fecal management device, or a usual care (UC) group (n = 247) that received standard care including regular perianal cleaning. Results. The FMS group reported lower incidence and severity of incontinence-associated dermatitis (IAD) and higher Braden Scale scores (10.42 ± 2.77) compared to the UC group (9.71 ± 2.56), indicating reduced pressure ulcer risk. Notably, FMS-associated complications were minimal, with only 5 patients (3.73%) affected; one required surgical intervention for rectal mucosal bleeding. Conclusions. FMS significantly reduced stool-associated skin irritation, lowered the incidence of IAD and pressure injuries, and improved nurses’ convenience compared to UC.