Parastomal Hernia Prevention, Assessment, and Management: A Scoping Review and Consensus-Based Best Practice...

Area of Science:

• Medical Science
• Surgical Nursing
• Clinical Practice Guidelines

Background:

• Parastomal hernias are a common complication for individuals with abdominal ostomies.
• Effective management and prevention strategies are crucial for patient quality of life.
• Existing guidelines for parastomal hernia care require comprehensive, consensus-based updates.

Purpose of the Study:

• To generate evidence-based, best practice recommendations for the prevention and management of parastomal hernias.
• To provide clear guidance for healthcare providers caring for ostomy patients at risk of or experiencing parastomal hernias.
• To establish consensus on optimal care strategies through expert review.

Main Methods:

• A comprehensive scoping literature review was conducted on parastomal hernia definitions, etiology, epidemiology, pathophysiology, assessment, prevention, and management.
• A modified Delphi method was employed to achieve consensus among expert panelists on best practice statements.
• Generated statements underwent external review by 28 professionals to validate recommendations.

Main Results:

• The scoping review informed the development of proposed consensus statements.
• Fifteen best practice recommendations achieved over 96% agreement among expert panelists.
• External review indicated that 96% of participants would recommend these guidelines for clinical practice.

Conclusions:

• Fifteen consensus-based best practice recommendations were generated to guide healthcare providers in assessing risk, preventing, and managing parastomal hernias.
• These recommendations synthesize current evidence and expert consensus for ostomy care.
• Further research is needed to establish definitive evidence-based preventive and treatment protocols for parastomal hernias.