1. Rod in loop ileostomy: just an insignificant detail for ileostomy-related complications?
- Author
-
Scarpa M, Sadocchi L, Ruffolo C, Iacobone M, Filosa T, Prando D, Polese L, Frego M, D'Amico DF, and Angriman I
- Subjects
- Adult, Aged, Female, Humans, Ileostomy adverse effects, Ileostomy economics, Male, Middle Aged, Postoperative Complications prevention & control, Pressure Ulcer prevention & control, Proctocolectomy, Restorative, Prospective Studies, Surgical Stomas, Ileostomy methods
- Abstract
Background and Aims: The aim of this prospective study was to validate a variant in the loop ileostomy construction to reduce peristomal pressure ulcers and, subsequently, the need of stoma therapist assistance and the frequency of changing the stoma appliance., Patients and Methods: We have enrolled 33 consecutive patients who underwent two stage restorative proctocolectomies. The first consecutive 13 patients operated on had their ileostomies constructed with a standard rod. In the following 20 patients, we placed a 5.3-mm suction catheter tube closed with a stitch to form a "ring" and without any stitches fixing it to the skin., Results: In the "ring" rod group 40% of patients did not report any complication compared to the 8% of patients in the standard rod group (p = 0.046). Pressure ulcers were absent in this group, while it affected 61% of the patients in the standard rod group (p < 0.001). Patients in the "ring" rod group needed significantly less assistance time by the stoma therapist (p < 0.01) and required significantly fewer stoma appliance changes (p < 0.01). In our institution, the overall cost for the complete management of a standard rod ileostomy was 73.16 (29.83-130.49) euro compared to 46.65 (23.15-93.48) euro for a "ring" rod ileostomy (p = 0.002)., Conclusions: The adoption of a "ring" rod configuration led to an elimination of pressure ulcers due to the rigid rod, a shorter time requirement for stoma care and a decreased number of appliances required and was subsequently associated with lower costs of assistance. A tighter fitting around the ileostomy that avoided stool infiltration improved the practical management of the stoma with a "ring" rod.
- Published
- 2007
- Full Text
- View/download PDF