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A Consensus on Stomal, Parastomal, and Peristomal Complications
Keryln Carville1, Emily Haesler, Tania Norman
1At Curtin University, Perth, Australia, Keryln Carville, PhD, RN, STN(Cred), is Associate Professor and Emily Haesler, PhD, is Professor. Tania Norman, RN, STN, BCN, is Stomal Therapy Nurse, St John of God Hospital, Murdoch, WA, Australia; Pat Walls, RN, STN, Cert Wound Mt, is Stomal Therapy Nurse at St Vincent's Private Hospital, Brisbane, Queensland, Australia. Leanne Monterosso, PhD, RN, is Professor and Chair of Nursing (Clinical Nursing) at the University of Notre Dame Australia, Fremantle. Acknowledgment: The authors gratefully acknowledge the research grant awarded by the Australian Association of Stomal Therapy Nurses that enabled this study; the stomal therapy nurses and colorectal surgeons who participated in the Delphi process and willingly gave of their time and expertise; and Paul Haesler, who designed and managed the project-specific online consensus voting platform. The authors have disclosed no financial relationships related to this article. Submitted to the World Council of Enterostomal Therapists Journal April 19, 2022; accepted May 2, 2022. Copyright Advances in Skin & Wound Care and the World Council of Enterostomal Therapists.
Objective:
To establish a consensus on terminology used to define stomal, parastomal, and peristomal complications in Australia.
Methods:
A list of stomal, parastomal, and peristomal complications was generated through group dialogue, which was informed by clinical and academic knowledge of the researchers. An extensive literature review was undertaken to identify any additional terms and to create a database of definitions/descriptions. A library of images related to the identified conditions was generated. An online Delphi process was conducted among a representative, purposive sample of Australia expert wound, ostomy, and continence nurses and colorectal surgeons. Ten terms were presented to the panel with descriptive photographs of each complication. Up to three Delphi rounds and, if necessary, a priority voting round were conducted.
Results:
Seven of the 10 terms reached agreement in the first round. One term ( allergic dermatitis ) was refined ( allergic contact dermatitis ) and reached agreement in the second round. Two terms ( mucocutaneous granuloma and mucosal granuloma ) were considered by the panel to be the same condition in different anatomical locations and were combined as one term ( granuloma ). Two terms ( skin stripping and tension blisters ) were combined as one term ( medical adhesive-related skin injury ) and reached agreement in round 2.
Conclusions:
A consensus in terminology used to describe stomal or parastomal/peristomal complications will enhance communication among patients and health professionals and advance opportunities for education and benchmarking of stomal, parastomal, and peristomal complications nationally.
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