A risk factor model for peristomal skin complications

Abstract

For people living with an ostomy, leakage and peristomal skin complications (PSC) are common issues that often appear together. Better means of preventing these issues could improve the quality of life of these patients. The purpose of the research presented here was to identify and build a model of risk factors for PSC.Risk factors were identified via discussion sessions with Coloplast's internal ostomy care experts, the Coloplast Skin Expert Panel, the Global Coloplast Ostomy Forum (COF), and 18 national COF boards, collectively representing more than 400 ostomy care nurses from around the world. Risk factors were identified by these expert groups, analysed, clustered into categories, and discussed in several stages, resulting in the risk factor model for PSC, comprising three overall categories and their related risk factors (n=24). Consensus on the model was achieved using a modified Delphi process involving over 4000 experts within ostomy care from 35 countries. In parallel, a systematic literature review of risk factors for PSC was performed to identify primary literature supporting the model. Relevant articles published from 2000 until August 2020 were included in the review, and 58 articles were found to support 19 out of the total 24 risk factors. The risk factor model for PSC was ratified by the Coloplast Skin Expert Panel and the Global COF and holds potential to be included in guidelines for healthcare professionals and to be used as a tool in daily clinical practice.

Clinical preventive-based best practices to reduce the risk of peristomal skin complications – an international consensus report

“…The Modified Delphi Process resulted in a strong consensus around the importance of maintaining peristomal integrity and the risk factors that must be considered in the prevention of PSC. The evidence identified in the literature review 13 and the experiential evidence gathered through the surveys and the facilitated dialogues led to the development and ratification of the PSC risk factor model (Figure 6).…”

“…Claessens et al 12 reported that 91% of people with an ostomy surveyed said they worry about leakage, 40% said they wake up at night because of their ostomy, 33% said that they limit their physical and social activities and 12% indicated that they socially isolate. However, while the literature supports a direct correlation between quality of life and PSC, understanding the risks to peristomal skin health are not well documented 13 .…”

“…PSC are well documented as the most prevalent complication faced by people with an ostomy and the most common reason people with an ostomy seek outpatient care and specialised ostomy nursing services 22 . However, there is minimal evidence in the literature to help healthcare professionals to engage in early identification of the risk factors for ostomy patients in developing PSC 13 . This project was designed to reach consensus among both clinical experts in ostomy care and nurses and practitioners around the world working with ostomy patients regarding risk factors that may cause PSC.…”