References

Claessens I, Probert R, Tielemans C The Ostomy Life Study: the everyday challenges faced by people living with a stoma in a snapshot. Gastrointestinal Nursing. 2015; 13:(5)18-25 https://doi.org/10.12968/gasn.2015.13.5.18

Colwell JC, McNichol L, Boarini J. North America wound, ostomy, and continence and enterostomal therapy nurses current ostomy care practice related to peristomal skin issues. J Wound Ostomy Continence Nurs. 2017; 44:(3)257-261 https://doi.org/10.1097/won.0000000000000324

Fellows J, Forest Lalande L, Martins L, Steen A, Størling ZM. Differences in ostomy pouch seal leakage occurrences between North American and European Residents. J Wound Ostomy Continence Nurs. 2017; 44:(2)155-159 https://doi.org/10.1097/won.0000000000000312

Grant M, McMullen CK, Altschuler A Gender differences in quality of life among long-term colorectal cancer survivors with ostomies. Oncol Nurs Forum. 2011; 38:(5)587-596 https://doi.org/10.1188/11.ONF.587-596

Gray M, Colwell JC, Doughty D Peristomal moisture-associated skin damage in adults with fecal ostomies: a comprehensive review and consensus. J Wound Ostomy Continence Nurs. 2013; 40:(4)389-399 https://doi.org/10.1097/WON.0b013e3182944340

Haugen V, Ratliff CR. Tools for assessing peristomal skin complications. J Wound Ostomy Continence Nurs. 2013; 40:(2)131-134 https://doi.org/10.1097/WON.0b013e31828001a7

Herlufsen P, Olsen AG, Carlsen B Study of peristomal skin disorders in patients with permanent stomas. Br J Nurs. 2006; 15:(16)854-862 https://doi.org/10.12968/bjon.2006.15.16.21848

Jemec GB, Martins L, Claessens I Assessing peristomal skin changes in ostomy patients: validation of the Ostomy Skin Tool. Br J Dermatol. 2011; 164:(2)330-335 https://doi.org/10.1111/j.1365-2133.2010.10093.x

Kini SP, DeLong LK, Veledar E, McKenzie-Brown AM, Schaufele M, Chen SC. The impact of pruritus on quality of life: the skin equivalent of pain. Arch Dermatol. 2011; 147:(10)1153-1156 https://doi.org/10.1001/archdermatol.2011.178

López-Jornet P, Camacho-Alonso F, Lucero-Berdugo M. Quality of life in patients with burning mouth syndrome. J Oral Pathol Med. 2008; 37:(7)389-394 https://doi.org/10.1111/j.1600-0714.2008.00672.x

Martins L, Ayello EA, Claessens I The ostomy skin tool: tracking peristomal skin changes. Br J Nurs. 2010; 19:(15)960-964 https://doi.org/10.12968/bjon.2010.19.15.77691

Martins L, Samai O, Fernández A, Urquhart M, Hansen AS. Maintaining healthy skin around an ostomy: peristomal skin disorders and self-assessment. Gastrointestinal Nursing. 2011; 9:9-13 https://doi.org/10.12968/gasn.2011.9.Sup2.9

Martins L, Tavernelli K, Sansom W Strategies to reduce treatment costs of peristomal skin complications. Br J Nurs. 2012; 21:(22)1312-1315 https://doi.org/10.12968/bjon.2012.21.22.1312

Meisner S, Lehur PA, Moran B, Martins L, Jemec GB. Peristomal skin complications are common, expensive, and difficult to manage: a population based cost modeling study. PLoS One. 2012; 7:(5) https://doi.org/10.1371/journal.pone.0037813

Nichols TR, Inglese GW. The burden of peristomal skin complications on an ostomy population as assessed by health utility and the physical component summary of the SF-36v2®. Value Health. 2018; 21:(1)89-94 https://doi.org/10.1016/j.jval.2017.07.004

Parnham A, Copson D, Loban T. Moisture-associated skin damage: causes and an overview of assessment, classification and management. Br J Nurs. 2020; 29:(12)S30-S37 https://doi.org/10.12968/bjon.2020.29.12.S30

Persson E, Gustavsson B, Hellström AL, Lappas G, Hultén L. Ostomy patients' perceptions of quality of care. J Adv Nurs. 2005; 49:(1)51-58 https://doi.org/10.1111/j.1365-2648.2004.03263.x

Pittman J, Bakas T, Ellett M, Sloan R, Rawl SM. Psychometric evaluation of the ostomy complication severity index. J Wound Ostomy Continence Nurs. 2014; 41:(2)147-157 https://doi.org/10.1097/won.0000000000000008

Richbourg L, Thorpe JM, Rapp CG. Difficulties experienced by the ostomate after hospital discharge. J Wound Ostomy Continence Nurs. 2007; 34:(1)70-79 https://doi.org/10.1097/00152192-200701000-00011

Salvadalena GD. The incidence of stoma and peristomal complications during the first 3 months after ostomy creation. J Wound Ostomy Continence Nurs. 2013; 40:(4)400-406 https://doi.org/10.1097/WON.0b013e318295a12b

Voegeli D, Karlsmark T, Eddes EH Factors influencing the incidence of peristomal skin complications: evidence from a multinational survey on living with a stoma. Gastrointestinal Nursing. 2020; 18:S31-S38 https://doi.org/10.12968/gasn.2020.18.Sup4.S31

Multinational survey on living with an ostomy: prevalence and impact of peristomal skin complications

09 September 2021
13 min read
Volume 30 · Issue 16

Abstract

Background:

Peristomal skin complications (PSCs) impair life for people with an ostomy. Visual signs of PSCs include discolouration, but sensation symptoms like pain, itching, and burning are equally important and underreported.

Aim:

To provide improved understanding of PSC prevalence and associated challenges in the communities of ostomy patients and ostomy care nurses.

Methods:

The Ostomy Life Study 2019 encompassed a patient survey (completed by 5187 people with an ostomy) and a nurse survey (completed by 328 ostomy care nurses).

Findings:

In total, 88% of patients experienced PSCs and 75% experienced PSC symptoms in the absence of discolouration. Eighty per cent of nurses considered ostomy-related issues to be the main reason for PSCs, and a correlation between PSC severity and number of nurse consultations was demonstrated.

Conclusion:

This study revealed a remarkably high PSC incidence in the absence of discolouration and highlighted direct consequences of having compromised skin and the health-economic consequences.

Peristomal skin complications (PSCs) are the most common postoperative complication following creation of an ostomy and remain a constant challenge for the majority of individuals with an ostomy. The incidence of PSCs is widely reported in the literature (Herlufsen et al, 2006; Richbourg et al, 2007; Gray et al, 2013; Salvadalena, 2013) and with great variability. Although a PSC rate of 18-60% has been summarised based on several investigations (Meisner et al, 2012), nurse specialists reported that nearly 80% of their patients developed PSCs (Colwell et al, 2017). These discrepancies in incidence reporting may reflect a non-systematic way of assessing PSCs among different health professionals (Martins et al, 2012). Importantly, the incidence of PSCs may be underreported by persons with ostomies partially due to them accepting that some degree of challenges associated with their ostomy are the ‘new normal’ and therefore they tend not to seek help and/or advice from a health professional.

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