Does the stoma site marking affect stoma quality?

Yıl 2024, Cilt: 31 Sayı: 2, 119 - 124, 29.06.2024

Salim İlksen Başçeken , Şeref Dokcu , Mehmet Ali Caparlar , Fatih Aslan , Salim Demirci

https://doi.org/10.17343/sdutfd.1312882

Öz

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.

Anahtar Kelimeler

stoma, WOC nurse, complication, stoma quality

Stoma bölgesinin işaretlenmesinin stoma kalitesine etkisi var mıdır?

Öz

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.

Anahtar Kelimeler

stoma, WOC hemşiresi, komplikasyon, stoma kalitesi

Kaynakça

• 1. Pine J, Stevenson L, On J. Intestinal stomas. Surg (United Kingdom) 2020;38(1):51–7.
• 2. Aktokmakyan TV, Ercetin C, Yigitbas H. A Retrospective Analysis of Determinants Affecting Intestinal Stomas. Clin J Surgery 2020;3(1):2–4.
• 3. Koc U, Karaman K, Gomceli I. A Retrospective Analysis of Factors Affecting Early Stoma Complications. Ostomy Wound Manage 2017;63(1):28–32.
• 4. Shabbir J, Britton DC. Stoma Complications: A Literature Overview. Colorectal Dis 2010;12(10):958–64.
• 5. Steinhagen E, Colwell J, Cannon LM. Intestinal Stomas--Postoperative Stoma Care and Peristomal Skin Complications. Clin Colon Rectal Surg 2017;30(3):184–92.
• 6. Tsujinaka S, Tan K-Y, Miyakura Y, Fukano R, Oshima M, Konishi F, et al. Current Management of Intestinal Stomas and Their Complications. J Anus, Rectum Colon 2020;4(1):25–33.
• 7. Taneja C, Netsch D, Rolstad BS, Inglese G, Lamerato L, Oster G. Clinical and economic burden of peristomal skin complications in patients with recent ostomies. J Wound, Ostomy Cont Nurs 2017;44(4):350–7.
• 8. Persson E, Berndtsson I, Carlsson E, Hallén AM, Lindholm E. Stoma-related Complications and Stoma Size - a 2-Year follow up. Colorectal Dis 2010;12(10):971–6.
• 9. Pilgrim CHC, McIntyre R, Bailey M. Prospective Audit of Parastomal Hernia: Prevalence and Associated Comorbidities. Dis Colon Rectum 2010;53(1):71–6.
• 10. Hsu MY, Lin JP, Hsu HH, Lai HL, Wu YL. Preoperative Stoma Site Marking Decreases Stoma and Peristomal Complications. J Wound Ostomy Cont Nurs 2020;47(June):249–56.
• 11. Bass EM, Del Pino A, Tan A, Pearl RK, Orsay CP, Abcarian H. Does Preoperative Stoma Marking and Education by the Enterostomal Therapist Affect Outcome? Dis Colon Rectum 1997;40(4):440–2.
• 12. Arolfo S, Borgiotto C, Bosio G, Mistrangelo M, Allaix ME, Morino M. Preoperative Stoma Site Marking: A Simple Practice to Reduce Stoma-Related Complications. Tech Coloproctol 2018;22(9):683–7.
• 13. Cottam J, Richards K, Hasted A, Blackman A. Results of a Nationwide Prospective Audit of Stoma Complications within 3 Weeks of Surgery. Color Dis 2007;9(9):834–8.
• 14. Colwell JC, Bain KA, Hansen AS, Droste W, Vendelbo G, James-Reid S. International Consensus Results: Development of Practice Guidelines for Assessment of Peristomal Body and Stoma Profiles, Patient Engagement, and Patient Follow-up. J Wound, Ostomy Cont Nurs 2019;46(6):497–504.
• 15. Kwiatt M, Kawata M. Avoidance and Management of Stomal Complications. Clin Colon Rectal Surg 2013;26(2):112–21.
• 16. Lindholm E, Persson E, Carlsson E, Hallén AM, Fingren J, Berndtsson I. Ostomy-related Complications After Emergent Abdominal Surgery a 2-Year follow-up Study. J Wound, Ostomy Cont Nurs 2013;40(6):603–10.