ASCN UK Guideline: parastomal hernias

North, Jacqui; Osborne, Wendy

doi:10.12968/bjon.2017.26.22.s6

Cited by 25 publications

(18 citation statements)

References 22 publications

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“…The most common stomal complication is PSH,5 7 which occurs when other abdominal contents protrude through the defect in the abdominal wall created for a stoma; prevalence is estimated to be over 30% by 12 months, 40% by 2 years and 50% or higher at long duration of follow-up 8. The UK Association of Stoma Care Nurses recommends ‘belts/underwear’ ‘to aid prevention of hernias and offer abdominal muscle support’ 9 10. Yet evidence supporting a recommendation for use of support garments to prevent or manage PSH is limited to a handful of small-scale studies using class 1 medical device underwear 11 12.…”

Section: Introductionmentioning

confidence: 99%

Experiences of support garments following bowel stoma formation: analysis of free-text responses in a cross-sectional survey

Hubbard

Taylor

Munro

et al. 2019

BMJ Open Gastroenterol

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AimTo explore the experiences of support garments when adjusting to bodily change following bowel stoma formation.DesignThematic analyses of free-text responses in a cross-sectional survey of the stoma population in 2018.MethodsFree-text responses were invited so that respondents could describe their experiences in more detail. A process of induction was chosen to allow for themes to emerge directly from the data. The concept ‘embodiment’ was used as a theoretical framework during interpretation.Results1425 people with a bowel stoma responded to the survey, of whom 598 provided free-text responses. Four themes about experiences of support garments in the context of changed bodily experiences following stoma formation were identified: body complications, which is about experiences of using support garments to prevent or self-manage parastomal hernia; body appearance, which is about hiding the stoma and stoma appliance; body function, which is about managing stoma appliance complications; and body sensation, which is mainly about negative experiences of ill-fitting garments.ConclusionSupport garments can be understood as items that are used by people during an ongoing process of adjusting to bodily changes following stoma formation and as part of an ongoing process of reconstructing new embodied selves.ImpactThis is the first study to explore people’s experiences of support garments following bowel stoma formation. Support garments are used in the self-management of body complications, appearance, function and sensations. Stoma nurses may draw on the findings of this study to advise patients about the benefits of garments for adjusting to bodily change, and garment suppliers should address people’s negative experiences by improving garments.

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Section: Introductionmentioning

confidence: 99%

Experiences of support garments following bowel stoma formation: analysis of free-text responses in a cross-sectional survey

Hubbard

Taylor

Munro

et al. 2019

BMJ Open Gastroenterol

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“…The CIPHER study in particular, as a joint venture involving the ASCN, aims to identify the key components of stoma formation that will inform surgical practice. This will ultimately dovetail into the current work being undertaken by ASCN UK (North and Osborne, 2017) and, as a result, will ensure that evidence-based interventions are implemented to prevent parastomal hernia.…”

Section: Wider Contextmentioning

confidence: 92%

“…Since this study, further work has been initiated by ASCN UK, which has led to the development of clinical guidelines (North and Osborne, 2017). From this and the other studies cited, it would seem evident that in order to prevent identifiable risk factors the assessment of patients prior to stoma surgery is beneficial.…”

Section: Preventionmentioning

confidence: 96%

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Using a risk assessment tool for parastomal hernia prevention

2018

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everal complications are associated with stoma surgery. These include skin irritation, leakages, dehydration, bowel obstruction and prolapse, but perhaps the most common problem is parastomal hernia (Williams et al, 2010). Described as a 'bulge' (Kald et al, 2008; Thompson, 2008), it can affect patients' bodyimage and self-confidence (North, 2014). Parastomal hernias are seen as a long-term complication of stoma surgery (Ripoche et al, 2011) because, following the formation of a stoma, a potential weakness is created within the abdominal muscle as a result of the surgical incision (Pilgrim et al, 2010; Aquina et al, 2014). Such a defect can, over time, allow a loop or loops of bowel to protrude through the abdominal wall, causing a bulge (Rolstad and Boarini, 1996; Kald et al, 2008). Not only does this bulge become visible as it protrudes through clothing, thereby presenting self-image issues for patients, but it also leads to appliance-fitting difficulties, which increases the risk of leakage. This, in turn, causes further distress for the patient with a stoma, as well as adding to the number of management issues that the specialist stoma care nurse needs to consider (Williams et al, 2010).

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“…Many stoma accessories and products are available on prescription to help manage these stoma-related complications (Burch, 2018). One type of accessory recommended by the UK Association of Stoma Care Nurses (ASCN) is the use of a support belt or muscle support (Association of Stoma Care Nurses UK, 2016; North and Osborne, 2017). It is suggested that a third of patients will develop a parastomal hernia (PSH) after ileal conduit diversion (Liu et al, 2013).…”

Section: Experiences Of Wearing Support Garments By People Living Witmentioning

confidence: 99%

Experiences of wearing support garments by people living with a urostomy

et al. 2019

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Background: support garments are commonly worn by people with a urostomy but there are no published data about their experiences of doing so. Aims: to identify the views of people living with a urostomy on the role of support garments. Methods: a cross-sectional survey of the stoma population's experiences of support garments was conducted in 2018. Recruitment was by social media. The free-text responses provided by a sub-sample of 58 people out of 103 respondents with a urostomy, were analysed. Findings: thematic analysis revealed four themes: physical self-management; psychosocial self-management; lifestyle; and healthcare advice and support. There were mixed feelings about the value of support garments. Many cited a sense of reassurance and confidence and being able to be more sociable and active; others reported discomfort and uncertainty about their value. Conclusion: these findings add new understanding of experiences of support garments and provide novel theoretical insights about life with a urostomy.

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ASCN UK Guideline: parastomal hernias

Cited by 25 publications

References 22 publications

Experiences of support garments following bowel stoma formation: analysis of free-text responses in a cross-sectional survey

Experiences of support garments following bowel stoma formation: analysis of free-text responses in a cross-sectional survey

Using a risk assessment tool for parastomal hernia prevention

Experiences of wearing support garments by people living with a urostomy

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