Background: Peristomal skin complications (PSCs) are frequently reported postoperative complications. PSCs can present visibly or as symptoms such as pain, itching or burning sensations. Aim: To develop a new tool that can capture a range of sensation symptoms together with visible complications and an objective assessment of discolouration in the peristomal area. Method: Consensus from qualitative interviews with health professionals and people with an ostomy, and input from expert panels, formed the basis of a patient-reported outcome (PRO) questionnaire. A decision tree model was used to define a combined score including PRO and objectively assessed discolouration area. Findings: Six elements were included in the PRO questionnaire and four health states representing different severity levels of the peristomal skin were defined. Conclusion: The Ostomy Skin Tool 2.0 is a sensitive tool that can be used to follow changes in the peristomal skin on a regular basis and thereby help prevent severe PSCs.

Background: Leakage is a common problem for people with a stoma. Aim: To investigate how people with a stoma and stoma care nurses perceive different patterns of effluent under the baseplate. Methods: The Ostomy Life Study 2019 included a user survey and a nurse survey covering experiences of leakage and the perception of leakage. Findings: Most people with a stoma perceived effluent reaching outside the baseplate as leakage (88–90%), whereas effluent close to the stoma only was not perceived as leakage by the majority (81–91%). Effluent covering major parts of the baseplate was perceived as leakage by most respondents with a colostomy or ileostomy (83%), whereas fewer respondents with a urostomy perceived this as leakage (57%). Most of the nurses (70%) did not perceive effluent close to the stoma as leakage. Conclusion: This study revealed that effluent confined to the area next to the stoma is generally not perceived as leakage.

For people living with an ostomy, leakage and peristomal skin complications (PSC) are common issues that often appear together. Better means of preventing these issues could improve the quality of life of these patients. The purpose of the research presented here was to identify and build a model of risk factors for PSC.Risk factors were identified via discussion sessions with Coloplast's internal ostomy care experts, the Coloplast Skin Expert Panel, the Global Coloplast Ostomy Forum (COF), and 18 national COF boards, collectively representing more than 400 ostomy care nurses from around the world. Risk factors were identified by these expert groups, analysed, clustered into categories, and discussed in several stages, resulting in the risk factor model for PSC, comprising three overall categories and their related risk factors (n=24). Consensus on the model was achieved using a modified Delphi process involving over 4000 experts within ostomy care from 35 countries. In parallel, a systematic literature review of risk factors for PSC was performed to identify primary literature supporting the model. Relevant articles published from 2000 until August 2020 were included in the review, and 58 articles were found to support 19 out of the total 24 risk factors. The risk factor model for PSC was ratified by the Coloplast Skin Expert Panel and the Global COF and holds potential to be included in guidelines for healthcare professionals and to be used as a tool in daily clinical practice.

Aim: The Ostomy Life Study 2019 aimed to obtain a better understanding of the challenges faced by people with stoma. Methods: Online survey with participants from 17 countries. Findings: Of the 54 614 individuals invited to take part, 5187 responded; 62% of the respondents avoided physical and social activities because of their stoma and 37% had never consulted their stoma care nurse to have the fit of their stoma product checked. In a subgroup receiving questions on leakage (n=4209), output under the baseplate and leakage onto clothes were experienced within the previous month by 76% and 26% of respondents, respectively. Higher chance of leakage was associated with an irregular stoma shape and peristomal body profile; a stoma level at or below the skin surface; and the presence of creases, folds and other changes in the peristomal area. Conclusion: Leakage and access to a stoma care nurse to provide the necessary care and guidance remain important concerns for individuals with a stoma.

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