Demographic and Clinical Factors Related to Ostomy Complications and Quality of Life in Veterans With an Ostomy

Abstract

This study found important relationships between demographic and clinical factors and ostomy complications. Skin problems, leakage, and difficulty adjusting predicted total quality of life scores and domains. Establishing relationships among ostomy complications and demographic, clinical factors, and quality of life can enhance identification of patients at risk for the development of complications and is an important first step in identifying the development of effective interventions to reduce the negative impact of complications for people with ostomies. Further study of predictors and outcomes of ostomy complications is needed to improve care.

Peristomal skin complications: causes, effects, and treatments

“…1,2,12 In obese patients, the mesentery of their stomas are thicker and shorter, making their stomas particularly at risk for these ischemic events that can result in a retracted stoma. 1,2,6,15 The leakage is even more severe with a retracted stoma where the os is located beneath the abdominal plane. The pooling is so frequent that with an ileostomy in particular, the skin damage occurs quickly and often, and as the skin is exposed to the effluent rich in proteolytic enzymes, increasing the risk for these stomas to progress from simple irritation to advanced wounds.…”

“…Structural characteristics such as stoma type, size, and location on the abdominal plane can affect the seal of the pouching system, and a poor fit can result in leakage and consequently irritation of the skin. 1,2,[6][7][8]11,15,16 Loop ileostomies represent the greatest proportion of peristomal skin complications in patients. In one study, 79% of the patients with a loop ileostomy suffered from a peristomal skin complication.…”

“…1,4,6,[8][9][10][11][12] Ileostomies, and in particular loop ileostomies, are responsible for the greatest proportion of peristomal skin complications. 1,2,[4][5][6]11 Complications range from mild irritation to full thickness ulcerations leading to pain, anxiety, and in some cases significant social isolation related to the pouching system leaks. 1,4,8,10 They are some of the most common postoperative complications, and usually occur within the first two weeks of the creation of the stoma.…”

“…[1][2][3][4][5][6][7][8][9] In principle, a stoma is an artificial opening through which the bowel protrudes, and is attached to the skin surface, allowing stool or urine to be diverted to the outside of the body. [4][5][6]9 The effluent must be separated from the skin, and contained within a pouching system that adheres to the skin. 5 Keeping this system working well and healthy is critical in maintaining a good, well-functioning stoma.…”

Positive correlation of employment and psychological well-being for veterans with major abdominal surgery

“…Problems related to ostomies include feelings of embarrassment, 1 sexuality, 2 coping, 3 spirituality,4 and overall HRQOL. 5 We have shown factors that have major roles in HRQOL in this population of patients including ostomy-related complications, 6 and difficulty paying for supplies? We also have found that comorbidities 8 actually may have a larger role in HRQOL than having an ostomy.…”