Does preoperative stoma marking and education by the enterostomal therapist affect outcome?

Abstract

These results confirm that preoperative evaluation by an enterostomal therapist, marking of the skin site, and providing patient education reduce adverse outcomes. All elective procedures that may result in stoma formation should, therefore, be assessed and marked preoperatively. Patients, likewise, should be informed and taught to care for their forthcoming stomas preoperatively and postoperatively.

Parastomal hernia

“…There is no evidence to support or refute the notion that closure of the lateral space reduces the incidence of herniation. Preoperative stoma marking by an enterostomal therapist reduces many adverse outcomes related to stomas 71,72 , but a reduction in hernia rates has not been demonstrated.…”

Cognitive Status and Functional Dexterity as Outcome Predictors Following Urinary Diversion: A Combined Retrospective and Prospective Observational Study

“…In the latter cases, caring for oneself poses a greater mental and physical challenge [21,22] than, for example, frequent bag changes in an ileal conduit patient. Moreover, as mentioned before, the prospering occupational group of stoma therapists [12] can ease and cover most of patients' needs after creation of a wet loop UD compared to patients after a continent solution. Therefore, we hypothesized that better patient selection on the basis of objective, validated clinical tests would increase the subjective functional outcome and therefore the medical care situation in UD patients and may provide the treating clinician with a useful tool regarding which UD he or she recommends.…”

“…Notably, these generally accepted preconditions have never been objectively defined in the past. As the act of catheterization places higher physical and mental demands on patients than stoma care (considering the growing role of stoma therapists [12]), proper preoperative patient selection is necessary. To date, besides objective parameters such as the underlying disease or anatomical considerations, the selection and recommendation which UD to use is governed by subjective evaluation of the treating clinician.…”

Current Trends in Urinary Diversion in Men

“…In this setting, patients should be aware that intraoperative pathological findings could modify the type of urinary diversion planned, as in the case of a short mesentery or cancer-related issues such as positive urethral margin, or gross extravesical disease precluding a negative surgical margin. For this reason, all patients planned for an ONR should have a stoma site marked preoperatively by an enterostomal therapist and at the same time have read and accepted the informed consent for an alternative urinary diversion [7,12,13]. In this way an absolute contraindication to continent diversion of any type is compromised renal function that results from long-standing obstruction or chronic renal failure, with serum creatinine levels above 150 to 200 mol/L.…”