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Ostomy-Related Complications After Emergent Abdominal Surgery: A 2-Year Follow-up Study.
Sahlgrenska University Hospital,Colorectal Unit.
University of Borås, School of Health Sciences.
Sahlgrenska Academy, University of Gothenburg, Institute for Care and Health Sciences.
Sahlgrenska University Hospital,Colorectal Unit.
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2013 (English)In: Journal of Wound, Ostomy and Continence Nursing (WOCN), ISSN 1071-5754, E-ISSN 1528-3976, Vol. 40, no 6, 603-610 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The aim of this study was to prospectively evaluate ostomy-related complications and describe ostomy configuration in patients undergoing acute abdominal surgery.

SUBJECTS AND SETTING: The study sample comprised 144 patients with a median age of 67 years (IOR: 53.5-78 years) who underwent an intestinal ostomy as part of an acute abdominal surgical procedure. The research setting was the surgical and gynecological clinics at the Sahlgrenska University Hospital in Gothenburg, Sweden.

METHODS: Ostomy configuration, diameter, height, and the presence of stomal and peristomal complications were assessed by a WOC nurse 1 to 2 times while in hospital, once at the ostomy outpatient clinic 2 weeks after discharge, and at 3, 6, 12, and 24 months following ostomy creation.

RESULTS: The types of ostomies evaluated were end colostomy (58%), end ileostomy (18%), loop ileostomy (17%), and loop colostomy (7%). Most stomal or peristomal complications occurred within 1 year after surgery (31 of 57; 54.4%). Necrosis, separation, and stenosis were most common in patients with an end colostomy. Peristomal skin complications occurred in 45% of subjects during the first 6 months after surgery. The ostomy's diameter decreased significantly during the hospital course and over the first 2 weeks following hospital discharge in patients with end colostomy (P < .0001), end ileostomy (P < .0081), loop ileostomy (P = .008), and loop colostomy (ns). Patients with a low ostomy had peristomal skin problems ranging between 21% and 57% over this time period. The frequency of using a pouching system that incorporated convexity was highest in the case of loop ileostomy, used in 67% at 6 months.

CONCLUSION: During the first 2 weeks after discharge, the physical configuration of the ostomy evolves and the pouching system must be frequently adjusted by a WOC nurse. Stomal and peristomal complications are prevalent during the first 2 postoperative years and especially during the first 6 months.

Place, publisher, year, edition, pages
2013. Vol. 40, no 6, 603-610 p.
Keyword [en]
Acute surgery, Colostomy, Complications, Enterostomal therapist, Ileostomy, Loop ileostomy, Ostomy, Ostomy configuration, Transverse colostomy
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-5632DOI: 10.1097/WON.0b013e3182a9a7d9ISI: 000330461700011PubMedID: 24108321Scopus ID: 2-s2.0-84888009028OAI: oai:DiVA.org:hv-5632DiVA: diva2:657218
Available from: 2013-10-18 Created: 2013-10-17 Last updated: 2014-09-08Bibliographically approved

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