Pouching System Leakage and Peristomal Skin Complications Following Ostomy Surgery in the Immediate Postoperative Period: A Retrospective Review.

Abstract

Purpose: The purpose of this study was to explore the performance of pouching systems with respect to leakage and the development of peristomal skin complications (PSCs) in an acute care setting immediately following ostomy creation.

Design: Non-experimental, retrospective cohort study.

Subjects and setting: The sample comprised 214 patients admitted for stoma-creation surgery at one of the 2 University of Pittsburgh Medical Center Presbyterian-Shadyside campuses located in the Northeastern United States (Pittsburgh, PA). Patients were seen in an in-patient care setting.

Methods: Electronic health records from patients who were in the hospital for ostomy creation surgery were reviewed by wound ostomy continence nurses from each hospital. Demographic and selected clinical data were collected. The main outcome variables used to evaluate pouching system performance were leakage and PSCs. These outcomes were assessed starting at pouch placement in the operating room and at every subsequent pouch change (up to 5) through discharge or 2 weeks following surgery.

Results: Use of an elastic tapeless barrier (ETB) significantly reduced the risk of leakage compared to a ceramide-infused tape-border barrier (CIB) for patients (41% reduced risk of leakage, P = .011). Use of the ETB also reduced leakage risk compared to the CIB for patients who experienced leakage 2 or more times during the observation period (31% reduction in leakage risk, P = .043). Five types of PSCs occurred during the study and statistical analysis indicated no significant differences in the number of PSCs was documented between barrier types.

Conclusion: The use of an ETB significantly reduced the risk of leakage compared to a CIB.