Stoma Leakage: Prevalence, Associated Factors, and Assessment Tools-A Scoping Review

Area of Science:

• Medical research
• Nursing science
• Stoma care

Background:

• Peristomal leakage is a significant complication for ostomates, impacting skin health, quality of life, and healthcare expenses.
• Existing data on peristomal leakage definitions, measurement, and prevalence are inconsistent.
• This scoping review addresses these inconsistencies by mapping prevalence, identifying factors, and describing assessment tools.

Purpose of the Study:

• To map the global prevalence of peristomal leakage across different stoma types.
• To identify factors associated with or correlated to peristomal leakage.
• To describe the tools currently used for assessing peristomal leakage.

Main Methods:

• A scoping review was conducted following Joanna Briggs Institute (JBI) guidelines.
• Searches were performed in major databases (MEDLINE, CINAHL, Scopus, Embase, Cochrane Library) for English and Italian studies.
• Included were primary studies and evidence syntheses focusing on peristomal leakage.

Main Results:

• Twenty-seven studies, primarily observational, were included, mostly from Europe, North America, and Nordic countries.
• Ileostomies were most studied, followed by colostomies and urostomies.
• High prevalence of peristomal leakage was observed (over 50% in most estimates), with multifactorial determinants (anatomical, surgical, device, behavioral, care, psychosocial).

Conclusions:

• Peristomal leakage is a prevalent, multifactorial complication with significant clinical, psychosocial, and economic implications.
• Clinical practice should emphasize early detection, validated assessment tools, patient education, specialized nursing, and structured follow-up.
• Future research needs to establish consensus definitions, validate assessment instruments, include diverse regions, and conduct economic evaluations for cost-effective care models.