Stoma and peristomal complications: a rapid overview of the literature
From Firenze University Press Journal: Infermieristica Journal
Giorgia Chirco, Fondazione Don Carlo Gnocchi, Firenze
Mario Antonini, Ostomy Rehabilitation Center (CE.RI.STOM) Azienda USL Toscana Centro, Empoli
Complications of the stoma complex are estimated to occur in 20–70% of the ostomized population. These studies, however, appear to show contradictions in terms of definitions of the same complications, making the results of the analyses of the incidence and prevalence of the phenomenon inconsistent with each other. The absence of unambiguous definitions does not allow clear evidence to be de!ned in science; moreover, this is rejected in the absence of a standardized clinical-care approach, which inevitably hinders the spread of an organizational and methodological culture aimed at the wellness and autonomy of the subject.
To overcome this obstacle, different classi!cations of complications have been proposed throughout the years, differentiating these exclusively into macro-categories, without delving into them in detail. In this regard, this review aims to clearly de!ne the individual complications of the stoma complex to provide nurses with an instrument that can help them in their prevention and recognition.
The presence of complications of the stoma complex is de!ned by the occurrence of unfortunate events that affect the stoma, mucocutaneous junction, and/or peristomal area, and that makes the management of the ostomy itself difficult or even exacerbate the health status of the subject. These have been recognized as negative indicators for the health of the ostomy patient1 and have been categorized in different ways. A study published in 2016, categorized them into surgical, psychological, and social complications; another classi!cation is related to the time of onset so that we can differentiate early complications, which develop within the first 72h after surgery, and late complications, which occur beyond 72h postoperatively.
The WOCN Society has separated stoma complex complications into two groups, stoma and peristomal complications.Several studies have been conducted over the years regarding the complications of the ostomy complex, mainly related to the risk factors determining these and the incidence of complications in the ostomized population. However, these studies included in the literature show variable results, so the incidence rate of complications varies from 20% to 70%, and to date, the risk factors contributing to their occurrence have not been de!ned with certainty. Salvadalena G. in 2013 and later, Malik et al. in 2018, in their related studies, highlighted the most representative limitations of the studies up to that time submitted literature. Both of them agree on how incoherencies in terms of definitions and measurements of complications represent a major limitation in establishing clear evidence.
In this regard, this review aims to clearly de!ne the complications of the ostomy complex and to provide nurses with an instrument that can help in the prevention, recognition, as well as the correct management of individual complications.
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