Just another stoma – why have we not improved?

Wille‐Jørgensen, Peer; Meisner, Søren

doi:10.1111/j.1463-1318.2010.02376.x

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…A key aspect in optimal stomal function relates to stomal construction. Two recent papers have reported on the importance of high quality stoma construction, including adequate stoma length to minimize leakage under the adhesive and consequently the possibility of PSC [3], [4].…”

Section: Discussionmentioning

confidence: 99%

“…Stoma complications occur with a high frequency in spite of careful pre-operative planning, continuously improving surgical technique and extensive surgical experience [2]. It has been suggested that the complication rate appears to have in fact remained the same for the last 50 years [3], despite major advances in other aspects of medical and surgical care over the same period. Stoma complications include necrosis, leakage, granuloma formation, retraction, stenosis, prolapsed and parastomal hernia, and peristomal skin diseases [4].…”

Section: Introductionmentioning

confidence: 99%

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Peristomal Skin Complications Are Common, Expensive, and Difficult to Manage: A Population Based Cost Modeling Study

Lehur²,

et al. 2012

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BackgroundPeristomal skin complications (PSCs) are the most common post-operative complications following creation of a stoma. Living with a stoma is a challenge, not only for the patient and their carers, but also for society as a whole. Due to methodological problems of PSC assessment, the associated health-economic burden of medium to longterm complications has been poorly described.AimThe aim of the present study was to create a model to estimate treatment costs of PSCs using the standardized assessment Ostomy Skin Tool as a reference. The resultant model was applied to a real-life global data set of stoma patients (n = 3017) to determine the prevalence and financial burden of PSCs.MethodsEleven experienced stoma care nurses were interviewed to get a global understanding of a treatment algorithm that formed the basis of the cost analysis. The estimated costs were based on a seven week treatment period. PSC costs were estimated for five underlying diagnostic categories and three levels of severity. The estimated treatment costs of severe cases of PSCs were increased 2–5 fold for the different diagnostic categories of PSCs compared with mild cases. French unit costs were applied to the global data set.ResultsThe estimated total average cost for a seven week treatment period (including appliances and accessories) was 263€ for those with PSCs (n = 1742) compared to 215€ for those without PSCs (n = 1172). A co-variance analysis showed that leakage level had a significant impact on PSC cost from ‘rarely/never’ to ‘always/often’ p<0.00001 and from ‘rarely/never’ to ‘sometimes’ p = 0.0115.ConclusionPSCs are common and troublesome and the consequences are substantial, both for the patient and from a health economic viewpoint. PSCs should be diagnosed and treated at an early stage to prevent long term, debilitating and expensive complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Peristomal Skin Complications Are Common, Expensive, and Difficult to Manage: A Population Based Cost Modeling Study

Lehur²,

et al. 2012

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“…Several types of questions are linked to specific points such as the height of the stoma , reversal and skin problems , but further research is also required for other clinically relevant issues . This would provide a foundation for continuous quality management as the individual clinician could base his or her care on an evaluation of actual data .…”

Section: Introductionmentioning

confidence: 99%