MANAGEMENT OF STOMA CARE: CASE STUDY

Abstract

Stoma created as an artificial opening in the abdominal area for the purpose of evacuation is often preferred because it is a life-saving method. Despite the developments in surgical techniques and the precautions taken with the development of technology, complications that develop in the stoma and the tissues around the stoma negatively affect the lives of individuals with stoma. After the stoma is opened, nursing care plays an important role in the prevention of complications, reduction of developing complications, and stoma care and treatment. In our case report, nursing care and interventions for opening the suture line, stoma retraction, dermatitis and wound complications in the peristomal area in an individual with loop ileostomy are included.

Keywords

• Stoma complication
• Stoma care
• Nursing care

STOMA BAKIMININ YÖNETİMİ: OLGU SUNUMU

Öz

Boşaltımın sağlanması amacıyla abdominal alanda yapay bir açıklık şeklinde oluşturulan stoma; hayat kurtaran bir yöntem olmasından dolayı, sıklıkla tercih edilmektedir. Teknolojinin gelişmesiyle beraber cerrahi tekniklerde meydana gelen gelişmeler ve alınan önlemlere rağmen, stoma ve stoma çevresindeki dokularda gelişen komplikasyonlar stomalı bireylerin yaşamını olumsuz yönde etkilemektedir. Stoma açıldıktan sonra, komplikasyonlarının önlenmesi, gelişen komplikasyonların azaltılması, stoma bakımı ve tedavisinde hemşirelik bakımını önemli rol oynamaktadır. Olgu sunumumuzda, loop ileostomi olan bir bireyde gelişen dikiş hattında açılma, stoma retraksiyonu, peristomal alanda dermatit ve yara komplikasyonlarına yönelik hemşirelik bakımı ve girişimleri yer almaktadır.

Anahtar Kelimeler

• Stoma bakımı
• Stoma komplikasyonu
• Hemşirelik bakımı

Kaynakça

1. Andersen R, Klausen T, Danielsen A, Vinther A, Gögenur I, Thomsen T. Incidence and risk factors for parastomal bulging in patients with ileostomy or colostomy: a register-based study using data from the Danish Stoma Database Capital Region. Colorectal Dis. 2018;20(4):331-340.
2. Ayık C, Özden D, Cenan, D. Ostomy complications, risk factors, and applied nursing care: A retrospective, descriptive study. Wound Management & Prevention. 2020; 66(9): 20- 30.
3. Beitz JM, Colwell JC. Management approaches to stomal and peristomal complications a narrative descriptive study. J Wound, Ostomy Cont Nurs. 2016; 43(3): 263– 268.
4. Karadağ A, Korkut H. Peristomal cilt komplikasyonları: Önleme, tedavi ve bakım. Ulusal Cerrahi Dergisi. 2010; 26: 175-179.
5. Bennett JL, Wick EC. Fecal diversion and ostomies. Gordon DA, Katlic MR, Editors. Pelvic Floor Dysfunction and Pelvic Surgery in the Elderly. New York: Springer; 2017. 349– 60. Özaydın İ, Taşkın AK,
6. Baykara ZG, Demir SG, Karadag A, Harputlu D, Kahraman A, Karadag S et al. A multicenter, retrospective study to evaluate the effect of preoperative stoma site marking on stomal and peristomal complications. Ostomy Wound Manage. 2014; 60: 16-26.
7. Butler, D. L. Early Postoperative Complications Following Ostomy Surgery: A Review. Journal of Wound Ostomy ve Continence Nursing,2009, 36(5), 513-519.
8. Carlsson E, Fingren J, Hallén AM, Petersen C, Lindholm E. The prevalence of ostomy-related complications 1 year after ostomy surgery: A prospective, descriptive, clinical study. Ostomy/Wound Management. 2016; 62(10): 34-48. 62

9. Carpenito-Moyet U. Nursing care plans & documentation: Nursing diagnoses and collaborative problems. 5. Edition. China: Lippincott Williams&Wilkins; 2009. 525-526.
10. Crawford, D., Texter, T., Hurt, K., VanAelst, R., Glaza, L., ve Vander Laan, K. J. (2012). Traditional nurse instruction versus 2 session nurse instruction plus DVD for teaching ostomy care: a multisite randomized controlled trial. Journal of Wound Ostomy ve Continence Nursing, 2012 39(5), 529-53
11. Cottam J, Richards K, Hasted A, Blackman A. Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery. Colorectal Disease. 2007; 9(9): 834– 838.
12. Colwell, J. C., ve Beitz, J. Survey of wound, ostomy and continence (WOC) nurse clinicians on stomal and peristomal complications: a content validation study. Journal of Wound Ostomy ve Continence Nursing, 2007, 34(1), 57-69.
13. Çalık B, Toptay H, Dursun A, Demirli S, Esin H. Intestinal Ostomies. Engin O, Editor. Colon Polyps and Colorectal Cancer. Switzerland: Springer Cham; 2021. 379-407 Erdemir, F. Türk, G (2022) Hemşirelik Tanıları El Kitabı, Ankara, Turkey , Nobel Tıp Kitapevleri, 4.Baskı
14. Harris, M. S., Kelly, K., ve Parise, C. Does preoperative ostomy education decrease anxiety in the new ostomy patient? A quantitative comparison cohort study. Journal of Wound Ostomy ve Continence Nursing, 2020).47(2), 137-139.
15. İskender A. Retrospective analysis of stoma-related complications. Journal of Clinical and Experimental Investigations. 2013; 4: 63-66.
16. Kann, B. R. Early stomal complications. Clinics in colon and rectal surgery,2008, 21(01), 023-030.
17. Laurence RS, Carlos SM. Re-operative surgery for intestinel stoma complications. Seminars in Colon and Rectal Surgery. 2015; 26: 200-205.
18. Motto GB, Bang GA, Ngoumfe JCC, Boukar YME, de Sendjong RLK, Nonga BN et al. Outcomes and Quality of Life of Patients with a Digestive Stoma in Sub- Saharan Africa: Case of the Yaounde Central Hospital, Cameroon. Surgical Science, 2021; 12(11): 381-389.
19. Pittman J. Stoma complications. Carmel JE, Colwell JC, Goldberg MT, Editors. Wound, Ostomy and Continence Nurse's Society Core Curriculum: Ostomy Management. 2. Edition. Philadelphia, PA: Wolters Kluwer; 2021. 191-199.
20. Pittman J, Bakas T, Ellett M, Sloan R, Rawl SM. Psychometric evaluation of the ostomy complication severity index. Journal of Wound, Ostomy Continence Nursing. 2014; 41: 147-157.
21. Ratliff, C. R. Early Peristomal Skin Complications Reported by WOC Nurses. Journal of Wound Ostomy ve Continence Nursing,2010; 37(5), 505-510.
22. Stelton S. CE: Stoma and peristomal skin care: A clinical review. American Journal of Nursing. 2019; 119: 38-45.
23. Türkmenoğlu, G., ve Karadağ, A. Problems Experienced by Spouses of Turkish Patients With a Stoma: A Descriptive, Cross-Sectional Study. Wound Management ve Prevention,2019, 65(11), 33-41.
24. Tyler JA, Fox JP, Dharmarajan S, et al. Acute health care resource utilization for ileostomy patients is higher than expected. Dis Colon Rectum. 2014; 57(12): 1412–1420.
25. Vural F, Erol F. Ostomili hastalarda yaşam kalitesi nasıl yükseltilir? Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi, 2013; 6(1): 34-39.
26. Vural F, Sütsünbüloğlu E, Şelimen D. Literature review: Profile of publications for the patients with stoma in Turkey. Turk Journal of Colorectal Disease. 2016; 26: 59-70.