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Stoma Komplikasyonları ve Hemşirelik Bakımı: Güncel Yaklaşımlar

Year 2023, Volume: 16 Issue: 3, 401 - 415, 15.07.2023
https://doi.org/10.46483/jnef.1327402

Abstract

Bağırsak stomaları, gastrointestinal sistem hastalıklarının cerrahi tedavisinde kullanılan yaygın bir girişimdir. Stoma açılması bireylerin sağ kalım oranlarını artırmakta ancak stoma ile ilgili komplikasyonlar ostomi ile yaşamanın olumsuz sonuçları olarak kabul edilmektedir. Stoma komplikasyonları, parastomal herni, prolapsus, mukokutanoz ayrılma, retraksiyon, nekroz, stenoz, travma ve fistülden oluşmaktadır. Stoma komplikasyonu ile ilgili literatür, stoma cerrahisi sonrası değişen oranlarda en az bir stoma komplikasyonu geliştiğini bildirmektedir. Pek çok komplikasyonun yönetiminde anahtar, komplikasyon gelişmesini önlemektir. Stoma cerrahisinin tekniğinin iyi olması ve stoma ve yara bakım hemşiresi tarafından komplikasyonların akıllıca yönetimi, hastanın iyileşmesinde önemli faktörlerdir. Bu nedenle hemşirelerin temel düzeyde stoma bakımı ve komplikasyon yönetiminde bilgi sahibi olması önemlidir. Bu derlemenin amacı stoma komplikasyonlarının önemli noktalarını vurgulayarak hemşirelere bir bakış açısı sağlamak ve komplikasyonlara yönelik hemşirelik yaklaşımlarını güncel rehberler ve çalışma sonuçları doğrultusunda sunmaktır.

References

  • Akgün, E., ve Yoldaş, T. (2012). Intestinal stoma. Kolon ve Rektum Hastalıkları Dergisi, 22, 133–146.
  • Antoniou, S. A., Agresta, F., Garcia Alamino, J. M., Berger, D., Berrevoet, F., Brandsma, H. T., Bury, K., Conze, J., Cuccurullo, D., Dietz, U. A., Fortelny, R. H., Frei-Lanter, C., Hansson, B., Helgstrand, F., Hotouras, A., Jänes, A., Kroese, L. F., Lambrecht, J. R., Kyle-Leinhase, I., … Muysoms, F. E. (2018). European Hernia Society guidelines on prevention and treatment of parastomal hernias. Hernia, 22(1), 183–198. https://doi.org/10.1007/s10029-017-1697-5
  • Association of Stoma Care Nurses UK. (2016, January). National Clinical Guidelines. ASCN UK. https://ascnuk.com/_userfiles/pages/files/national_guidelines.pdf
  • Ayik, C., Özden, D., ve Cenan, D. (2020). Ostomy complications, risk factors, and applied nursing care: A retrospective, descriptive study. Wound Management ve Prevention, 66(9), 20–30. https://doi.org/10.25270/wmp.2020.9.2030
  • Baker, M., ve Greening, L. (2009). Practical management to reduce and treat complications of high-output stomas. Gastrointestinal Nursing, 7(6), 10–17. https://doi.org/10.12968/gasn.2009.7.6.43344
  • Baykara, Z. G., Demir, S. G., Karadag, A., Harputlu, D., Kahraman, A., Karadag, S., Hin, A. O., Toyluk, E., Altinsoy, M., Erdem, S., ve Cihan, R. (2014). A Multicenter, retrospective study to evaluate the effect of preoperative stoma site marking on stomal and peristomal Complications. Ostomy Wound Management, 60(5), 16–26.
  • Bednarski, B. K., Slack, R. S., Katz, M., You, Y. N., Papadopolous, J., Rodriguez-Bigas, M. A., Skibber, J. M., Matin, S. F., ve Chang, G. J. (2018). Assessment of ileostomy output using telemedicine. Diseases of the Colon ve Rectum, 61(1), 77–83. https://doi.org/10.1097/DCR.0000000000000945
  • Beitz, J. M., ve Colwell, J. C. (2014). Stomal and peristomal complications: Prioritizing management approaches in adults. Journal of Wound, Ostomy and Continence Nursing, 41(5), 445–454. https://doi.org/10.1097/WON.0000000000000052
  • Beitz, J. M., ve Colwell, J. C. (2016). Management approaches to stomal and peristomal complications: A Narrative Descriptive Study. Journal of Wound, Ostomy and Continence Nursing, 43(3), 263–268. https://doi.org/10.1097/WON.0000000000000215
  • Bordeianou, L., Paquette, I., Johnson, E., Holubar, S. D., Gaertner, W., Feingold, D. L., ve Steele, S. R. (2017). Clinical practice guidelines for the treatment of rectal prolapse. Diseases of the Colon ve Rectum, 60(11), 1121–1131. https://doi.org/10.1097/DCR.0000000000000889
  • Carlsson, E., Fingren, J., Hallén, A.-M., Petersén, C., ve Lindholm, E. (2016). The prevalence of ostomy-related complications 1 year after ostomy surgery: A Prospective, descriptive, clinical study. Ostomy Wound Management, 62(10), 34–48.
  • Claessens, I., Probert, R., Tielemans, C., Steen, A., Nilsson, C., Andersen, B. D., ve Størling, Z. M. (2015). The Ostomy Life Study: The everyday challenges faced by people living with a stoma in a snapshot. Gastrointestinal Nursing, 13(5), 18–25. https://doi.org/10.12968/gasn.2015.13.5.18
  • Colwell, J. C., ve Beitz, J. (2007). Survey of wound, ostomy and continence (WOC) nurse clinicians on stomal and peristomal complications: A content validation study. Journal of Wound, Ostomy and Continence Nursing, 34(1), 57–69. https://doi.org/10.1097/00152192-200701000-00010
  • Cottam, J., Richards, K., Hasted, A., ve Blackman, A. (2007). Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery. Colorectal Disease, 9(9), 834–838. https://doi.org/10.1111/j.1463-1318.2007.01213.x
  • Faury, S., Koleck, M., Foucaud, J., M’Bailara, K., ve Quintard, B. (2017). Patient education interventions for colorectal cancer patients with stoma: A systematic review. Patient Education and Counseling, 100(10), 1807–1819. https://doi.org/10.1016/j.pec.2017.05.034
  • Fish, D. R., Mancuso, C. A., Garcia-Aguilar, J. E., Lee, S. W., Nash, G. M., Sonoda, T., Charlson, M. E., ve Temple, L. K. (2017). Readmission after ileostomy creation. Annals of Surgery, 265(2), 379–387. https://doi.org/10.1097/SLA.0000000000001683
  • Goldberg, M., Colwell, J., Burns, S., Carmel, J., Fellows, J., Hendren, S., Livingston, V., Nottingham, C. U., Pittman, J., Rafferty, J., Salvadalena, G., Steinberg, G., Palmer, R., ve Bonham, P. (2018). WOCN Society Clinical Guideline: Management of the adult patient with a fecal or urinary ostomy —An Executive summary. Journal of Wound, Ostomy and Continence Nursing, 45(1), 50–58. https://doi.org/10.1097/WON.0000000000000396
  • Goodey, A., ve Colman, S. (2016). Safe management of ileostomates with high-output stomas. British Journal of Nursing, 25(22), S4–S9. https://doi.org/10.12968/bjon.2016.25.22.S4
  • Hendren, S., Hammond, K., Glasgow, S. C., Perry, W. B., Buie, W. D., Steele, S. R., ve Rafferty, J. (2015). Clinical practice guidelines for ostomy surgery. Diseases of the Colon ve Rectum, 58(4), 375–387. https://doi.org/10.1097/DCR.0000000000000347
  • Hoeflok, J., Salvadalena, G., Pridham, S., Droste, W., McNichol, L., ve Gray, M. (2017). Use of convexity in ostomy care: Results of an international consensus meeting. Journal of Wound, Ostomy and Continence Nursing, 44(1), 55–62. https://doi.org/10.1097/WON.0000000000000291
  • Hsu, M.-Y., Lin, J.-P., Hsu, H.-H., Lai, H.-L., ve Wu, Y.-L. (2020). Preoperative stoma site marking decreased stoma and peristomal complications. Journal of Wound, Ostomy and Continence Nursing, 47(3), 249–256. https://doi.org/10.1097/WON.0000000000000634
  • Justiniano, C. F., Temple, L. K., Swanger, A. A., Xu, Z., Speranza, J. R., Cellini, C., Salloum, R. M., ve Fleming, F. J. (2018). Readmissions with dehydration after ileostomy creation. Diseases of the Colon ve Rectum, 61(11), 1297–1305. https://doi.org/10.1097/DCR.0000000000001137
  • Karadağ, A. (2016). Peristomal cilt komplikasyonları: tanılama, önleme, tedavi. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 3(1), 72–83.
  • Koc, U., Karaman, K., Gomceli, I., Dalgic, T., Ozer, I., Ulas, M., Ercan, M., Bostanci, E., ve Akoglu, M. (2017). A retrospective analysis of factors affecting early stoma complications. Ostomy Wound Management, 63(1), 28–32.
  • Krishnamurty, D. M., Blatnik, J., ve Mutch, M. (2017). Stoma Complications. Clinics in Colon and Rectal Surgery, 30(3), 193–200. https://doi.org/10.1055/s-0037-1598160
  • Krouse, R. S., Grant, M., McCorkle, R., Wendel, C. S., Cobb, M. D., Tallman, N. J., Ercolano, E., Sun, V., Hibbard, J. H., ve Hornbrook, M. C. (2016). A chronic care ostomy self-management program for cancer survivors. Psycho-Oncology, 25(5), 574–581. https://doi.org/10.1002/pon.4078
  • Kwiatt, M., ve Kawata, M. (2013). Avoidance and management of stomal complications. Clinics in Colon and Rectal Surgery, 26(02), 112–121. https://doi.org/10.1055/s-0033-1348050
  • Lindholm, E., Persson, E., Carlsson, E., Hallén, A.-M., Fingren, J., ve Berndtsson, I. (2013). Ostomy-related complications after emergent abdominal surgery. Journal of Wound, Ostomy ve Continence Nursing, 40(6), 603–610. https://doi.org/10.1097/WON.0b013e3182a9a7d9
  • Mackowski, A., Chen, H.-K., ve Levitt, M. (2015). Successful management of chronic high-output ileostomy with high dose loperamide. BMJ Case Reports, 1–3. https://doi.org/10.1136/bcr-2015-209411
  • Makowsky, M. J., Bell, P., ve Gramlich, L. (2019). Subcutaneous magnesium sulfate to correct high-output ileostomy-induced hypomagnesemia. Case Reports in Gastroenterology, 13(2), 280–293. https://doi.org/10.1159/000501121
  • Medlin, S. (2012). Nutritional and fluid requirements: high-output stomas. British Journal of Nursing, 21(Sup6), S22–S25. https://doi.org/10.12968/bjon.2012.21.Sup6.S22
  • Merino, P., Martín, M. C., Alonso, A., Gutiérrez, I., Álvarez, J., ve Becerril, F. (2013). Medication errors in Spanish intensive care units. Medicina Intensiva, 37(6), 391–399. https://doi.org/10.1016/j.medine.2012.11.004
  • Messaris, E., Sehgal, R., Deiling, S., Koltun, W. A., Stewart, D., Mckenna, K., ve Poritz, L. S. (2012). Dehydration is the most common indication for readmission after diverting ileostomy creation. Diseases of the Colon and Rectum, 55(2), 175–180. https://doi.org/10.1097/DCR.0b013e31823d0ec5
  • Murken, D., ve Bleier, J. (2019). Ostomy-Related Complications. Clinics in Colon and Rectal Surgery, 32(03), 176–182. https://doi.org/10.1055/s-0038-1676995
  • Nastro, P., Knowles, C. H., McGrath, A., Heyman, B., Porrett, T. R. C., ve Lunniss, P. J. (2010). Complications of intestinal stomas. British Journal of Surgery, 97(12), 1885–1889. https://doi.org/10.1002/bjs.7259
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Ostomy Complications and Nursing Care: Current Approaches

Year 2023, Volume: 16 Issue: 3, 401 - 415, 15.07.2023
https://doi.org/10.46483/jnef.1327402

Abstract

Intestinal ostomy is a common surgical intervention to treat diseases of gastrointestinal tract. Ostomy creation increases the survival rates of individuals; however, it is regarded as one of the negative consequences of living with ostomy. Stoma complications consist of parastomal hernia, prolapse, mucocutaneous separation, retraction, necrosis, stenosis, and fistula. The literature relevant to stoma complications reports that varying rates of at least one stoma complication occur after ostomy creation. The key element in managing several stoma complications is to prevent it. Proper construction technique of ostomy surgery and management of complications by a wound and ostomy nurse are essential factors for patient’s recovery. Therefore, it is important for nurses to have basic knowledge about ostomy care and complication management. In this review, stoma complications will highlight to provide a perspective for nurses and nursing managements for these complications will be presented based on current guidelines and studies.

References

  • Akgün, E., ve Yoldaş, T. (2012). Intestinal stoma. Kolon ve Rektum Hastalıkları Dergisi, 22, 133–146.
  • Antoniou, S. A., Agresta, F., Garcia Alamino, J. M., Berger, D., Berrevoet, F., Brandsma, H. T., Bury, K., Conze, J., Cuccurullo, D., Dietz, U. A., Fortelny, R. H., Frei-Lanter, C., Hansson, B., Helgstrand, F., Hotouras, A., Jänes, A., Kroese, L. F., Lambrecht, J. R., Kyle-Leinhase, I., … Muysoms, F. E. (2018). European Hernia Society guidelines on prevention and treatment of parastomal hernias. Hernia, 22(1), 183–198. https://doi.org/10.1007/s10029-017-1697-5
  • Association of Stoma Care Nurses UK. (2016, January). National Clinical Guidelines. ASCN UK. https://ascnuk.com/_userfiles/pages/files/national_guidelines.pdf
  • Ayik, C., Özden, D., ve Cenan, D. (2020). Ostomy complications, risk factors, and applied nursing care: A retrospective, descriptive study. Wound Management ve Prevention, 66(9), 20–30. https://doi.org/10.25270/wmp.2020.9.2030
  • Baker, M., ve Greening, L. (2009). Practical management to reduce and treat complications of high-output stomas. Gastrointestinal Nursing, 7(6), 10–17. https://doi.org/10.12968/gasn.2009.7.6.43344
  • Baykara, Z. G., Demir, S. G., Karadag, A., Harputlu, D., Kahraman, A., Karadag, S., Hin, A. O., Toyluk, E., Altinsoy, M., Erdem, S., ve Cihan, R. (2014). A Multicenter, retrospective study to evaluate the effect of preoperative stoma site marking on stomal and peristomal Complications. Ostomy Wound Management, 60(5), 16–26.
  • Bednarski, B. K., Slack, R. S., Katz, M., You, Y. N., Papadopolous, J., Rodriguez-Bigas, M. A., Skibber, J. M., Matin, S. F., ve Chang, G. J. (2018). Assessment of ileostomy output using telemedicine. Diseases of the Colon ve Rectum, 61(1), 77–83. https://doi.org/10.1097/DCR.0000000000000945
  • Beitz, J. M., ve Colwell, J. C. (2014). Stomal and peristomal complications: Prioritizing management approaches in adults. Journal of Wound, Ostomy and Continence Nursing, 41(5), 445–454. https://doi.org/10.1097/WON.0000000000000052
  • Beitz, J. M., ve Colwell, J. C. (2016). Management approaches to stomal and peristomal complications: A Narrative Descriptive Study. Journal of Wound, Ostomy and Continence Nursing, 43(3), 263–268. https://doi.org/10.1097/WON.0000000000000215
  • Bordeianou, L., Paquette, I., Johnson, E., Holubar, S. D., Gaertner, W., Feingold, D. L., ve Steele, S. R. (2017). Clinical practice guidelines for the treatment of rectal prolapse. Diseases of the Colon ve Rectum, 60(11), 1121–1131. https://doi.org/10.1097/DCR.0000000000000889
  • Carlsson, E., Fingren, J., Hallén, A.-M., Petersén, C., ve Lindholm, E. (2016). The prevalence of ostomy-related complications 1 year after ostomy surgery: A Prospective, descriptive, clinical study. Ostomy Wound Management, 62(10), 34–48.
  • Claessens, I., Probert, R., Tielemans, C., Steen, A., Nilsson, C., Andersen, B. D., ve Størling, Z. M. (2015). The Ostomy Life Study: The everyday challenges faced by people living with a stoma in a snapshot. Gastrointestinal Nursing, 13(5), 18–25. https://doi.org/10.12968/gasn.2015.13.5.18
  • Colwell, J. C., ve Beitz, J. (2007). Survey of wound, ostomy and continence (WOC) nurse clinicians on stomal and peristomal complications: A content validation study. Journal of Wound, Ostomy and Continence Nursing, 34(1), 57–69. https://doi.org/10.1097/00152192-200701000-00010
  • Cottam, J., Richards, K., Hasted, A., ve Blackman, A. (2007). Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery. Colorectal Disease, 9(9), 834–838. https://doi.org/10.1111/j.1463-1318.2007.01213.x
  • Faury, S., Koleck, M., Foucaud, J., M’Bailara, K., ve Quintard, B. (2017). Patient education interventions for colorectal cancer patients with stoma: A systematic review. Patient Education and Counseling, 100(10), 1807–1819. https://doi.org/10.1016/j.pec.2017.05.034
  • Fish, D. R., Mancuso, C. A., Garcia-Aguilar, J. E., Lee, S. W., Nash, G. M., Sonoda, T., Charlson, M. E., ve Temple, L. K. (2017). Readmission after ileostomy creation. Annals of Surgery, 265(2), 379–387. https://doi.org/10.1097/SLA.0000000000001683
  • Goldberg, M., Colwell, J., Burns, S., Carmel, J., Fellows, J., Hendren, S., Livingston, V., Nottingham, C. U., Pittman, J., Rafferty, J., Salvadalena, G., Steinberg, G., Palmer, R., ve Bonham, P. (2018). WOCN Society Clinical Guideline: Management of the adult patient with a fecal or urinary ostomy —An Executive summary. Journal of Wound, Ostomy and Continence Nursing, 45(1), 50–58. https://doi.org/10.1097/WON.0000000000000396
  • Goodey, A., ve Colman, S. (2016). Safe management of ileostomates with high-output stomas. British Journal of Nursing, 25(22), S4–S9. https://doi.org/10.12968/bjon.2016.25.22.S4
  • Hendren, S., Hammond, K., Glasgow, S. C., Perry, W. B., Buie, W. D., Steele, S. R., ve Rafferty, J. (2015). Clinical practice guidelines for ostomy surgery. Diseases of the Colon ve Rectum, 58(4), 375–387. https://doi.org/10.1097/DCR.0000000000000347
  • Hoeflok, J., Salvadalena, G., Pridham, S., Droste, W., McNichol, L., ve Gray, M. (2017). Use of convexity in ostomy care: Results of an international consensus meeting. Journal of Wound, Ostomy and Continence Nursing, 44(1), 55–62. https://doi.org/10.1097/WON.0000000000000291
  • Hsu, M.-Y., Lin, J.-P., Hsu, H.-H., Lai, H.-L., ve Wu, Y.-L. (2020). Preoperative stoma site marking decreased stoma and peristomal complications. Journal of Wound, Ostomy and Continence Nursing, 47(3), 249–256. https://doi.org/10.1097/WON.0000000000000634
  • Justiniano, C. F., Temple, L. K., Swanger, A. A., Xu, Z., Speranza, J. R., Cellini, C., Salloum, R. M., ve Fleming, F. J. (2018). Readmissions with dehydration after ileostomy creation. Diseases of the Colon ve Rectum, 61(11), 1297–1305. https://doi.org/10.1097/DCR.0000000000001137
  • Karadağ, A. (2016). Peristomal cilt komplikasyonları: tanılama, önleme, tedavi. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 3(1), 72–83.
  • Koc, U., Karaman, K., Gomceli, I., Dalgic, T., Ozer, I., Ulas, M., Ercan, M., Bostanci, E., ve Akoglu, M. (2017). A retrospective analysis of factors affecting early stoma complications. Ostomy Wound Management, 63(1), 28–32.
  • Krishnamurty, D. M., Blatnik, J., ve Mutch, M. (2017). Stoma Complications. Clinics in Colon and Rectal Surgery, 30(3), 193–200. https://doi.org/10.1055/s-0037-1598160
  • Krouse, R. S., Grant, M., McCorkle, R., Wendel, C. S., Cobb, M. D., Tallman, N. J., Ercolano, E., Sun, V., Hibbard, J. H., ve Hornbrook, M. C. (2016). A chronic care ostomy self-management program for cancer survivors. Psycho-Oncology, 25(5), 574–581. https://doi.org/10.1002/pon.4078
  • Kwiatt, M., ve Kawata, M. (2013). Avoidance and management of stomal complications. Clinics in Colon and Rectal Surgery, 26(02), 112–121. https://doi.org/10.1055/s-0033-1348050
  • Lindholm, E., Persson, E., Carlsson, E., Hallén, A.-M., Fingren, J., ve Berndtsson, I. (2013). Ostomy-related complications after emergent abdominal surgery. Journal of Wound, Ostomy ve Continence Nursing, 40(6), 603–610. https://doi.org/10.1097/WON.0b013e3182a9a7d9
  • Mackowski, A., Chen, H.-K., ve Levitt, M. (2015). Successful management of chronic high-output ileostomy with high dose loperamide. BMJ Case Reports, 1–3. https://doi.org/10.1136/bcr-2015-209411
  • Makowsky, M. J., Bell, P., ve Gramlich, L. (2019). Subcutaneous magnesium sulfate to correct high-output ileostomy-induced hypomagnesemia. Case Reports in Gastroenterology, 13(2), 280–293. https://doi.org/10.1159/000501121
  • Medlin, S. (2012). Nutritional and fluid requirements: high-output stomas. British Journal of Nursing, 21(Sup6), S22–S25. https://doi.org/10.12968/bjon.2012.21.Sup6.S22
  • Merino, P., Martín, M. C., Alonso, A., Gutiérrez, I., Álvarez, J., ve Becerril, F. (2013). Medication errors in Spanish intensive care units. Medicina Intensiva, 37(6), 391–399. https://doi.org/10.1016/j.medine.2012.11.004
  • Messaris, E., Sehgal, R., Deiling, S., Koltun, W. A., Stewart, D., Mckenna, K., ve Poritz, L. S. (2012). Dehydration is the most common indication for readmission after diverting ileostomy creation. Diseases of the Colon and Rectum, 55(2), 175–180. https://doi.org/10.1097/DCR.0b013e31823d0ec5
  • Murken, D., ve Bleier, J. (2019). Ostomy-Related Complications. Clinics in Colon and Rectal Surgery, 32(03), 176–182. https://doi.org/10.1055/s-0038-1676995
  • Nastro, P., Knowles, C. H., McGrath, A., Heyman, B., Porrett, T. R. C., ve Lunniss, P. J. (2010). Complications of intestinal stomas. British Journal of Surgery, 97(12), 1885–1889. https://doi.org/10.1002/bjs.7259
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There are 49 citations in total.

Details

Primary Language Turkish
Subjects Nursing (Other)
Journal Section Reviews
Authors

Cahide Ayik 0000-0002-1766-3965

Dilek Özden This is me 0000-0001-8139-5558

Publication Date July 15, 2023
Published in Issue Year 2023 Volume: 16 Issue: 3

Cite

APA Ayik, C., & Özden, D. (2023). Stoma Komplikasyonları ve Hemşirelik Bakımı: Güncel Yaklaşımlar. Etkili Hemşirelik Dergisi, 16(3), 401-415. https://doi.org/10.46483/jnef.1327402

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