The Ostomy Skin Tool 2.0: a new instrument for assessing peristomal skin changes

Abstract

Background: Peristomal skin complications (PSCs) are frequently reported postoperative complications. PSCs can present visibly or as symptoms such as pain, itching or burning sensations. Aim: To develop a new tool that can capture a range of sensation symptoms together with visible complications and an objective assessment of discolouration in the peristomal area. Method: Consensus from qualitative interviews with health professionals and people with an ostomy, and input from expert panels, formed the basis of a patient-reported outcome (PRO) questionnaire. A decision tree model was used to define a combined score including PRO and objectively assessed discolouration area. Findings: Six elements were included in the PRO questionnaire and four health states representing different severity levels of the peristomal skin were defined. Conclusion: The Ostomy Skin Tool 2.0 is a sensitive tool that can be used to follow changes in the peristomal skin on a regular basis and thereby help prevent severe PSCs.

Healthcare resource use and associated costs for patients with an ileostomy experiencing peristomal skin complications

“…In light of the above, a modified OST, known as the OST 2.0, has recently undergone validation; Figure 1 provides further detail on the processes of the decision tree. Using a decision tree, PSCs are categorised based on predefined symptoms including peristomal ulcers; peristomal bleeding; peristomal weeping; pain, itch, or burning sensation; and discolouration 28 . The OST 2.0 assesses a greater range of symptoms than the OST and uses an artificial intelligence‐based approach to assess the area of peristomal skin affected by discoloration.…”

“…As a result, in addition to the existing categories of ‘mild,’ ‘moderate,’ and ‘severe’ PSCs (but excluding ‘normal skin’), the OST 2.0 includes an additional ‘no treatment required’ category. Individuals presenting with exclusively peristomal discolouration will be categorised as having ‘no treatment required’ if they have ≤10 cm 2 discoloured skin or ‘mild’ if they have >10 cm 2 28 …”

“…The hierarchy of the decision tree model shows the overall severity level of PSCs for each subject. The model can be used to divide subjects into four different categories, depending on the combination of symptoms: ‘severe’ PSC, ‘moderate’ PSC, ‘mild’ PSC, and ‘no treatment required’ PSC 28 . This figure has been directly obtained from the original paper and is reporting the same data.…”

Algorithm for Indication of Collector Equipment for Stomas

“…Faced with this information and experiences, a team of stoma therapist nurses and technical advisors felt motivated to seek instruments for better positioning and indication of their portfolio of company products and, thus, contribute to favoring the care practice and minimize the problems encountered in the indication of the most appropriate collection equipment for each situation 7 .…”

Algoritmo De Indicação De Equipamento Coletor Para Estomias

“…Frente a essas informações e vivências, uma equipe de enfermeiros estomaterapeutas e assessores técnicos sentiram-se motivados a buscar instrumentos para melhor posicionamento e indicação do portfólio de produtos da empresa, e assim, contribuir para favorecer a prática assistencial e minimizar os problemas encontrados na indicação do equipamento coletor mais adequado a cada situação 7 .…”