Peristomal Skin Complications in the First 12 Weeks Post-discharge Following Urinary/Fecal Stoma Formation Surgery.

Abstract

Objective: Ostomates often develop complications to the peristomal skin, which impact recovery and rehabilitation. The aim of this study was to determine the number, type, and etiology of peristomal skin complications (PSC) experienced by a cohort of ostomates in the first 12 weeks postdischarge from hospital following surgery that resulted in a fecal or urinary stoma.

Methods: Nineteen patients with newly formed stomas were recruited by stomal therapy nurses (STNs) from 2 large hospitals in Perth, Western Australia. Baseline data were collected before discharge; ostomates then were reviewed weekly for 4 weeks, and then fortnightly until 12 weeks. Peristomal skin assessments were conducted, and photographic images taken and assessed by the researcher and an independent expert.

Results: Nineteen ostomates were recruited, 2 withdrew, and the remaining 17 were followed through for 12 weeks or until reversal of their stoma (if temporary). One hundred percent of ostomates presented with one or more PSCs, 74% (n=14) were attributed to irritant dermatitis, which was directly related to a leaking appliance, and 53% (n=10) had PSCs that were classified as bruising. None of the PSCs were classified as severe, with many ostomates not recognizing that they had a PSC.

Conclusions: The results from this study align with the PSCs reported in the international literature and highlight the importance of regular postoperative STN follow-up, especially in the early postoperative period. The study has identified the main contributing factors for PSCs, which can be used to identify ostomates at high risk of developing PSCs and guide prevention strategies.