Challenges faced by people with a stoma: peristomal body profile risk factors and leakage

Martins, Lina; Andersen, Birgitte Dissing; Colwell, Janice C.; Down, Gillian; Forest-Lalande, Louise; Nováková, Svatava; Probert, Rosalind; Hedegaard, Chris Juul; Hansen, Anne Steen

doi:10.12968/bjon.2022.31.7.376

Cited by 20 publications

(10 citation statements)

References 27 publications

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“…Leakage of stomal effluent is a common problem for people with a stoma [13]. Currently available products within stoma care do not sufficiently enable users to take proactive care to avoid leakage progressing outside the baseplate and address the mental burden of worrying about leakage.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a novel digital ostomy device on leakage incidents, quality of life, mental well-being, and patient self-care: an interventional, multicentre clinical trial

Brady,

Sheard,

Alty

et al. 2024

Preprint

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BackgroundMost people with a stoma worry about leakage, and a quarter experience leakage of stomal effluent outside baseplate on a monthly basis. Leakage has additional physical and psychosocial consequences, for instance peristomal skin complications, feeling unable to cope and self-isolation.MethodAn interventional, single-arm, multi-centre, study was undertaken in United Kingdom, to evaluate a novel digital leakage notification system for ostomy care including a Support Service (=Test Product) for 12 weeks in patients with a recent stoma formation (≤9 months). Patients completed questionnaires at baseline and after 4, 6, 8, 10 and 12 weeks, evaluating leakage episodes, Ostomy Leak Impact (tool containing three domains) and patient self-management (by PAM-13). Additionally, mental well-being (by WHO-5) and quality of life (QoL) (by EQ-5D-5L) were assessed. Outcomes between baseline and final evaluation were compared by generalised linear- and linear mixed models.Results92 patients (ITT population) were recruited with a mean age of 49.4-years (range 18-81 years). 80% had an ileostomy and 53% were female. After 12 weeks use of the Test Product, a significant decrease in mean episodes of leakage outside the baseplate (1.57 versus 0.93,P<0.046) was observed. Ostomy Leak Impact scores improved across all three domains (P<0.001), indicating less embarrassment, increased engagement in social activities, and increased control. Patient self-management also improved significantly (PAM-13 score: Δ6.6,P<0.001), as did the WHO-5 well-being index (Δ8.0,P<0.001). Lastly, EQ-5D-5L-profile-scores tended to improve (P=0.075).ConclusionA new digital leakage notification system demonstrated strong improvements to patients’ stoma self-care, mental well-being, and QoL.What does this paper add to the literature?Sensor technology embedded in supporting ostomy solutions can notify users about leakage seeping underneath the baseplate and thus secure a timely change of the baseplate before effluent may reach outside the baseplate soiling clothes or bedsheets. The technology showed potential in increasing quality of life for people with a stoma.

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Section: Discussionmentioning

confidence: 99%

Evaluation of a novel digital ostomy device on leakage incidents, quality of life, mental well-being, and patient self-care: an interventional, multicentre clinical trial

Brady,

Sheard,

Alty

et al. 2024

Preprint

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“…In recent years, ostomy products have been the subject of innovation and development to improve the fit or the performance of the ostomy pouching system. However, recent research showed that leakage and PSC are still impacting peoples' lives and causing worries among people with an ostomy 65,66 . In a broader perspective, risk factors other than those inherent to ostomy products may offer unexplored opportunities to prevent leakage and skin issues by other means.…”

Section: Discussionmentioning

confidence: 99%

A risk factor model for peristomal skin complications

Hansen¹,

Bechshøft²,

Martins³

et al. 2022

wcet

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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.

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“…For individuals who require convexity, a key challenge is selecting a correct fitting baseplate to maintain an adequate seal while minimising the risk of pressure injuries [ 3 , 5 , 6 ]. This challenge is compounded by significant patient-to-patient variation such as differences in skin folds, levels of abdominal fat, skin fragility, stoma size, and stoma protrusion [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of Stoma Baseplate Convexity on Tension and Compression Around the Stoma Site: A Finite Element Analysis

Waller,

Gowans,

Lord

et al. 2024

Cureus

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For patients living with intestinal or urinary stomas, skin barriers play an essential role in protecting the peristomal skin and preventing peristomal complications. Convex baseplates press into the peristomal skin and are suitable for retracted stomas that do not protrude, peristomal skin with creases, folds, or dips, and stomas where frequent leaking can occur with flat pouching systems. However, there is a lack of data on the magnitude and location of tension applied to the abdomen by convex baseplates. We evaluated the impact of a range of convex baseplates applied to a simulated stoma site. A comparative finite element analysis investigation was conducted to evaluate the impact of eight different convex stoma system baseplates applied to an idealised flat abdomen, representing skin, subcutaneous tissue, and musculature layers. The baseplates considered had varying convexity with depths of 3.5 mm and 7 mm and internal structural diameters between ~30 mm and ~60 mm. The convex product range provided tension in the skin (maximum principal strain) and compression through the fat layer (minimum principal strain). Large differences in the locations and magnitudes of skin tension and fat layer compression were seen between the baseplates under analysis, with both the depth and diameter of convexity influencing the strain experienced across the abdominal topography. The results generated highlight the importance of having an appropriate range of convexity products available and selecting an appropriate option for use based on the stoma type and condition of the peristomal skin.

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Challenges faced by people with a stoma: peristomal body profile risk factors and leakage

Cited by 20 publications

References 27 publications

Evaluation of a novel digital ostomy device on leakage incidents, quality of life, mental well-being, and patient self-care: an interventional, multicentre clinical trial

Evaluation of a novel digital ostomy device on leakage incidents, quality of life, mental well-being, and patient self-care: an interventional, multicentre clinical trial

A risk factor model for peristomal skin complications

Impact of Stoma Baseplate Convexity on Tension and Compression Around the Stoma Site: A Finite Element Analysis

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