Stoma bölgesinin işaretlenmesinin stoma kalitesine etkisi var mıdır?

Abstract

ÖZ Amaç Stoma yapımı kolorektal cerrahi prosedürlerin vazgeçilmez parçasıdır. Cerrahlar stoma ile yapmış oldukları anastomozun morbiditesinden kurtulmayı ummaktadırlar. Stomalar hem oluşturulma hem de kapanmaları esnasında yüksek morbidite kaynağıdırlar. Sorunsuz stomalar hem sağlık maliyetlerini azaltır, hemde hasta yaşam kalitesini desteklerler. Bu çalışmamızda stoma ve yara bakımı hemşiresi tarafından ameliyat öncesi yapılan işaretlemenin stoma kalitesi ile ilişkisini ortaya koymayı amaçladık. Gereç ve Yöntemler Çalışmaya onkoloji kliniğimizde malign tanılarla opere edilip stoma oluşturma ihtiyacı duyulan 150 hasta dahil edildi. Hastaların WOC hemşiresince tutulan tıbbi kayıtları ve veri tabanı geriye dönük olarak incelendi. Demografik ve klinikopatolojik veriler kaydedilip, gruplandırıldı. Hem acil hem de elektif prosedürler geçiren hastalar çalışmaya dahil edildi. İstatistiksel analizler yüzde 95 güven aralığında yapıldı. P değerinin 0,05'ten küçük olması istatistiksel olarak anlamlı kabul edildi. Bulgular Stoma bölgesinin işaretlenme durumu ve VKİ ile, komplikasyonlar arasında anlamlı bir ilişki izlendi, (p=0.03, p=0,01). İleostomili hastalar kolostomili hastalardan anlamlı derecede fazla peristomal cilt komplikasyonlarıyla ( PSC) ilişkiliydi, (p=0.02).Yine yapılan fark analizinde de stoma işaretleme durumu ile stoma çapları arasında anlamlı bir farklılaşma izlendi, büyük stoma çapları WOC hemşiresince konsulte edilmeyen hastalarla ilişkiliydi, (p=0,001). Sonuç Bulgular WOC hemşiresi tarafından operasyon öncesi yapılacak olan konsültasyonun stoma kalitesini etkileyen komplikasyonlar ve stoma çapı ile ilişkili olduğunu göstermiştir.

Keywords

• stoma
• WOC hemşiresi
• komplikasyon
• stoma kalitesi

Does the stoma site marking affect stoma quality?

Abstract

Objective: Ostomy structure is an indispensable part of colorectal surgical procedures. With stoma, surgeons hope to get rid of the morbidity of the anastomosis they made. Ostomies are the source of morbidity both during construction and closure. Problem-free ostomies both reduce healthcare costs and support patients' quality of life. In this study, we aimed to reveal the relationship between the marking performed by the wound, ostomy and continence nurse (WOC nurse) before surgery and the quality of the stoma. Material and Method: 150 patients who underwent surgery for malignant diagnosis in our oncology clinic and needed stoma construction were included in the study. The medical records and database of the patients kept by the WOC nurse were retrospectively reviewed. Demographic and clinicopathological data were recorded and grouped. Patients who underwent both emergency and elective procedures were included in the study. Statistical analyzes were performed within the 95% confidence interval. A p-value of less than 0.05 was considered statistically significant. Results: A significant relationship was observed between the marking the stoma site and BMI with the complications (p=0.03, p=0,01). Patients with ileostomy were associated with significantly more peristomal skin complications (PSC) than patients with a colostomy (p=0.02). Again, in the different analyses performed, a significant difference was observed between stoma marking status and stoma diameters; large stoma diameters were associated with patients who were not consulted by the WOC nurse (p=0.001). Conclusion: The findings showed that WOC nurse preoperative consultation was associated with fewer complications affecting stoma quality.

Keywords

• stoma
• WOC nurse
• complication
• stoma quality

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