References
Leakage of stomal effluent outside the baseplate leads to rise in product usage and health professional interactions
Abstract
Background:
Leakage of stomal effluent outside the baseplate that soils clothes or bedsheets is a common problem for many people with a stoma and significantly impacts their quality of life.
Aim:
To understand behavioural changes for people experiencing faecal leakage outside the baseplate regarding the usage of pouching systems, supporting products and interactions with health professionals.
Methods:
Retrospective, self-reported questionnaire.
Findings:
Respondents on average experienced 1.1 incidents of faecal leakage outside the baseplate per fortnight. In periods with issues of leakage, 21% of respondents had been in contact with health professionals, 40% increased their use of pouching systems, 25% increased their use of existing supporting products, and 21% included additional supporting products to their change routine. The increased use of healthcare resources was estimated to cost £32.47 in the 3 weeks following a leakage incident.
Conclusion:
Incidents of leakage outside the baseplate lead to increased use of healthcare resources.
Many people living with a stoma struggle with psychosocial and physical problems after stoma surgery, with leakage of stomal effluent and peristomal skin complications (PSCs) among the most common stoma-related issues experienced (Fellows et al, 2021; Jeppesen et al, 2022).
Although the term ‘leakage’ is widely used, there is no standard definition for this, and understanding of the term varies between users and health professionals (Down et al, 2021). Nafees et al (2018) suggested distinguishing between two broad definitions of leakage, ‘leakage underneath the baseplate’ and ‘leakage outside the baseplate’.
In a recent international survey, 65% of people living with a stoma had experienced leakage of effluent outside the baseplate at least once in the previous year and 26% had experienced this monthly (Martins et al, 2022). Another study found that leakage issues continued to be a problem from the early postoperative period to several years after surgery (Pearson et al, 2020). Leakage of stomal effluent progressing outside the baseplate (eg onto clothes or bed sheets) can be socially embarrassing, is often distressing and is always inconvenient for the individual to experience, with more than 90% of people living with a stoma worrying about leakage (Claessens et al, 2015; Jeppesen et al, 2022). Leakage of stomal effluent and the worry thereof have a significant negative impact on people's quality of life (QoL), especially when effluent progresses outside the baseplate, soiling clothes or bedsheets.
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