Parastomal hernia: an exploration of the risk factors and the implications

Abstract

Risk may be defined as 'the chance that something may happen to cause loss or an adverse effect' (Concise Oxford Medical Dictionary, 2003). Patients undergoing stoma formation are at risk of developing a wide range of complications following surgery. A parastomal hernia is an adverse effect that can contribute to postoperative morbidity. The risk of developing a parastomal hernia is dependent upon a number of variables, and stoma care nurses need to be aware of these to plan the appropriate care for patients undergoing stoma formation. This article discusses the issues surrounding the development of parastomal hernias and also looks at ways in which the risk factors associated with the development of a parastomal hernia may be minimized.

The Prevention and Treatment of Stoma Complications. A Report of 152 Cases

“…Patients undergoing stoma formation are at risk of developing a wide range of complications following surgery (12). There are many factors suggested to predispose to stoma complications like high body mass index, (13).…”

“…But like other surgical procedures stoma formation may also results in local, systemic and psychological complications (12,22).…”

Ventral hernia: Patient selection, treatment, and management

“…Primary fascial repair involves hernia reduction and primary fascial approximation through a peristomal incision. As is the case with primary suture repair for incisional ventral hernia, primary fascial repair for parastomal hernia is associated with a high rate of recurrence; however, it offers the benefit of not entering the abdominal cavity which is useful in a patient with a hostile abdomen or concerns for wound complications 236 . The overall cumulated risk of recurrence after 3 years was 10.8% (95% CI 0-22.3).…”

Nurse activity to prevent and support patients with a parastomal hernia

“…The incidence of PSH in the UK is estimated at around 30% of all ostomists (temporary and permanent) and found to be more common in colostomates (McGrath, Porrett and Heyman, 2006), although international incidence of parastomal hernias are difficult to estimate, as definitions vary worldwide (Salvadalena, 2008). The true aetiology of PSH development is unknown as predisposing factors associated with PSH are mostly based on expert opinions rather than scientific evidence (Pilgrim, McIntyre and Bailey, 2010).…”