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A multinational evaluation assessing the relationship between peristomal skin health and health utility

14 March 2019
13 min read
Volume 28 · Issue 5



irritation to peristomal skin remains one of the most prevalent ostomy-related complications influencing an individual's health status and quality of life.


to assess the impact of damaged peristomal skin on the health utility and quality-adjusted life days (QALD) in an international adult ostomy population.


a cross-sectional survey incorporating the SF-6D preference-based health utility index was developed to assess a random selection of post-surgical patients.


health utility decreased with increasing skin irritation among the three geographic groups. The total mean health utility of normal peristomal skin for the three groups dropped incrementally for mild, moderate, and severe irritation. There were no differences in health utility or QALDs between the three country groups.


improvement of peristomal skin health is associated with improvements to QALDs. Clinicians, caregivers and patients have the responsibility to address a critical unmet need in skin health through interventions and products designed to support healthy peristomal skin.

Advances in medical innovations have resulted in the ability of patients with gastrointestinal disease to manage their care through the broader availability of biological therapies. In fact, reports have demonstrated that care for patients with inflammatory bowel diseases and colorectal cancer have shifted to the use of targeted biological therapies (Kriza et al, 2013; van der Valk et al, 2016). Despite these advances, surgery with the intent to create an abdominal stoma to support the management of benign and malignant gastrointestinal problems is still prevalent globally.

A stoma is an opening on the abdomen that can be connected to either the digestive or urinary system to allow waste (urine or faeces) to be diverted out of the body (Bladder and bowel Community, 2019). Effluent from the stoma is collected by an ostomy pouch that is attached to the skin surrounding the stoma (peristomal skin) by an adhesive barrier. Leakage of effluent to the peristomal skin is a major complication, creating not only a psychological burden concerning 9 out of 10 patients (Claessens et al, 2015), but also a clinical burden that leads to irritation and skin injury (Herlufsen et al, 2006).

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