Utilities associated with stoma-related complications: peristomal skin complications and leakages

Rolls, Natasha; Yssing, Cecilie; Bøgelund, Mette; Håkan‐Bloch, Jonas; Jensen, L.

doi:10.1080/13696998.2022.2101776

Cited by 10 publications

(7 citation statements)

References 32 publications

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“…The EQ-5D-5L instrument was used to measure patients' HRQoL, which can be used for economic evaluations and comparisons [27]. The baseline EQ-5D-5L index score was in the present study found to be 0.713 (UK specific), which is similar to scores for people with a stoma experiencing 1 to 4 leakage incidents per month reported in a time-trade-off study [28]. This is markedly lower than the score reported for the general population in England (0.885) [29].…”

Section: Discussionsupporting

confidence: 76%

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: Discussionsupporting

confidence: 76%

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

View full text Add to dashboard Cite

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“…2,3 Additionally, peristomal skin complications are associated with high ostomy treatment costs, increasing the need for effective interventions to prevent or minimize their severity. 9 This case study describes a less common but challenging complication of PA. Firstline treatment includes an initial incision and drainage of the abscess with daily wound care. However, in our case, Ms T's wound was only 0.2 cm from her stoma.…”

Section: Discussionmentioning

confidence: 99%

“…Resulting peristomal skin complications are especially prevalent in patients with an ileostomy due to higher amount and more corrosive ostomy effluent 2,3. Additionally, peristomal skin complications are associated with high ostomy treatment costs, increasing the need for effective interventions to prevent or minimize their severity 9…”

Section: Discussionmentioning

confidence: 99%

Management of a Peristomal Abscess in a Patient With an Ileostomy

Wei,

Qiu,

et al. 2024

Journal of Wound, Ostomy &Amp; Continence Nursing

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BACKGROUND: Peristomal abscess (PA) is an uncommon but challenging peristomal skin complication. The initial treatment of the PA usually includes incision and drainage of the abscess, resulting in a peristomal wound. The presence of the wound makes it difficult to maintain a seal between the ostomy skin barrier and the peristomal skin resulting in frequent removal and application of the skin barrier to prevent leakage and allow for daily wound care. CASE: Ms T was a 52-year-old woman with an ileostomy resulting from a prior left hemicolectomy for colon cancer who developed a PA. Treatment of the PA was implemented, along with a modified 2-piece skin barrier that allowed access to the peristomal wound for daily dressing changes while maintaining a seal around the ostomy. CONCLUSION: The modified 2-piece skin barrier technique proved a successful treatment for the management of the PA without frequent changes of the ostomy pouching system.

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“…16 Leakage can be debilitating to experience for the individual as it may lead to embarrassing situations. Leakage has been associated with reductions in QoL, 2,26 lower health states as determined in a time trade-off study, 19 and an increased risk of social isolation. 2 Use of a concave skin barrier was related to significantly fewer leakage episodes and higher ostomy-specific QoL in the present study and supports similar correlations between leakage reduction and QoL improvements reported by others.…”

Section: Discussionmentioning

confidence: 99%

“…2,18,19 Leakage may lead to embarrassing situations, leaving people with increased anxiety related to the possibility of leakage, and overall, it exerts a negative impact on QoL. 2,19 Furthermore, effluent situated on the skin is a key determinant for development of peristomal skin complications (PSCs). 18 Application of flat skin barriers on curved body shapes can result in the development of folds and wrinkles, enhancing the risk for undermining and leakage.…”

Section: Introductionmentioning

confidence: 99%

Body Fit With a Pouching System With Concave Contour for People With an Outward Peristomal Body Profile

Rolfsen,

Vestergaard,

Hansen

et al. 2024

Journal of Wound, Ostomy &Amp; Continence Nursing

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PURPOSE: The purpose of the study was to investigate the fit of a two-piece pouching system with a concave-shaped skin barrier on people with an outward peristomal body profile and its effect on leakage, wear time, and quality of life (QoL) related to using an ostomy product. DESIGN: Randomized, controlled, open-label, cross-over trial. SUBJECTS AND SETTINGS: The sample comprised 53 subjects with outward peristomal body profiles and problems with leakage of ostomy effluent from their pouching system. Participants were randomized to the concave two-piece pouching system or a comparator (two-piece pouching system with a flat skin barrier) for 3 weeks. Subjects were then crossed over to the opposite skin barrier for an additional 3 weeks. The study was conducted in Denmark, Norway, Germany, and the Netherlands; data were collected in multiple ambulatory clinics or during home visits. METHODS: The primary end point was the ability of the skin barrier to fit body contours; secondary outcomes were leakage of effluent from the pouching system, wear time, and QoL related to using an ostomy product via the validated Ostomy-Q questionnaire. Primary comparisons between concave and comparator pouching systems were evaluated using proportional odds models and mixed models taking test period into account. RESULTS: Analysis included randomized subjects who had been exposed to at least one product and with information on at least one end point (full-analysis-set, n = 52). The concave pouching system provided a better fit to body contours than the comparator (P< .001) and reduced the degree of leakage underneath the skin barrier (LS mean difference = −1.84, 95% CI −3.31 to −0.37; P = .016). Participants experienced fewer episodes of leakage outside the skin barrier when using concave versus comparator pouching system (13.0% vs. 26.7%, respectively). Participants reported significant improvements in QoL (LS mean difference = 14.3; 95% CI 9.4 to 19.2; P < .001). No significant difference in wear time between skin barrier shapes was reported. CONCLUSIONS: Study findings indicate that a pouching system with a concave skin barrier achieved a better body fit on people with an outward peristomal body profile and resulted in fewer leakage incidents and higher QoL compared to using a pouching system with a flat skin barrier.

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Utilities associated with stoma-related complications: peristomal skin complications and leakages

Cited by 10 publications

References 32 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

Management of a Peristomal Abscess in a Patient With an Ileostomy

Body Fit With a Pouching System With Concave Contour for People With an Outward Peristomal Body Profile

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