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Evaluating skin care problems in people with stomas
Julia Williams1, Brandon Gwillam, Norma Sutherland
1Burdett Institute of Gastrointestinal Nursing in partnership with King's College London and St Mark's Hospital, Harrow.
British Journal of Nursing (Mark Allen Publishing)
|September 28, 2010
Summary
Peristomal skin problems are common in ostomates, with many unaware of their condition. Regular stoma nurse follow-up and education are crucial for managing skin health and appliance fit.
Area of Science:
- Stoma care and wound management
- Dermatology in ostomy patients
- Patient-reported outcomes in stoma care
Background:
- Maintaining peristomal skin integrity is fundamental for effective stoma management.
- Patients with stomas frequently encounter peristomal skin issues, necessitating clinical advice.
- Limited data exists on the prevalence, clinical course, and self-management of peristomal skin problems.
Purpose of the Study:
- To identify and categorize actual and potential peristomal skin problems in ostomates.
- To assess the impact of different stoma appliances and accessories on peristomal skin health.
- To compare ostomates' self-reported skin condition with assessments by stoma care nurse specialists.
Main Methods:
- A multi-centered descriptive study involving 80 ostomates over 13 months.
- Data collection via structured questionnaires and interviews conducted by stoma care nurse specialists.
- Objective assessment of peristomal skin using digital photography and the Stoma Care Ostomy Research index scoring system.
Main Results:
- 68% of ostomates exhibited peristomal skin problems upon observation, including irritation (44%), ulceration (12%), allergies (9%), and maceration/erosion (3%).
- 21% had ill-fitting appliances, and 50% had parastomal hernias, though only 24% reported hernias.
- Significant discrepancies were found between ostomates' perceived and observed peristomal skin conditions.
Conclusions:
- Peristomal skin issues are highly prevalent among ostomates.
- Disparities in perception highlight educational needs for ostomates regarding skin condition and appliance management.
- Regular follow-up and education by stoma care nurse specialists are essential for optimal patient outcomes.
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An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
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