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The Use of a Stoma Rod/Bridge to Prevent Retraction: A Systematic Review
Eleftherios Gialamas1,2,3,4,5,6, Jeremy Meyer1,2,3,4,5,6, Ziad Abbassi1,2,3,4,5,6
1Eleftherios Gialamas, MD, Division of Digestive Surgery, University Hospitals of Geneva, Geneva, Switzerland; and Unit of Surgical Research, University of Geneva, Geneva, Switzerland.
Purpose:
We evaluated evidence related to the use of a rod (bridge) to prevent stoma retraction during loop ostomy construction.
Methods:
We completed a systematic review of the literature. We searched MEDLINE, EMBASE, and COCHRANE databases up to December 4, 2019. We posed the following question based on a PICO format. Do adult patients undergoing ostomy surgery experience less stomal retraction when compared to patients managed without placement of a stoma rod?
Findings:
Our initial search returned 182 articles; after reading studies in full, 5 articles were identified that collectively enrolled 1058 participants. Four studies were randomized controlled trials and one was a prospective cohort study. Meta-analysis could not be performed because of the small number of studies and the heterogeneity of outcomes measurements. The incidence of stoma retraction ranged between 0%-8% in patients managed with a rod and 0.78%-8.2% in patients with no rod. The number of reported adverse events was low. Placement of a stoma rod was associated with more adverse outcomes than in patients managed without a rod. Adverse events included local edema, stoma necrosis, skin necrosis, peristomal moisture-associated skin damage (irritant dermatitis), peristomal abscess, bleeding, and mucocutaneous separation.
Conclusions:
Stoma rod does not seem to reduce the risk of stoma retraction and might result in other adverse events.
Implications:
We recommend avoidance of stoma rod/bridge placement during ostomy surgery.
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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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