Aplicación de convexidad ligera y anillos moldeables en ostomía para evitar fugas en el postoperatorio precoz del paciente con ostomía digestivaestudio CONAN

  1. María José Fabeiro Mouriño 1
  2. Julia Romero Moreno 2
  3. Mercedes Coca López 3
  4. Carmen Diarte Abenia 4
  5. María Pilar Pardo Roda 5
  6. Eduardo García Blázquez 6
  1. 1 Enfermera estomaterapeuta. Hospital Álvaro Cunqueiro. Vigo (España)
  2. 2 Enfermera especializada en coloproctología y estomaterapia. Psicóloga. Hospital Universitario La Fe. Valencia (España)
  3. 3 Enfermera experta en práctica avanzada en ostomías. Hospital Universitario Nuestra Señora de Valme. Sevilla (España)
  4. 4 Enfermera estomaterapeuta. Hospital Clínico Universitario Lozano Blesa. Zaragoza (España)
  5. 5 Enfermera estomaterapeuta. Hospital Lucus Augusti. Lugo (España)
  6. 6 Market Manager Ostomy Care. Coloplast. Madrid (España)
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Revista:
Metas de enfermería

ISSN: 1138-7262

Ano de publicación: 2022

Volume: 25

Número: 7

Páxinas: 14-22

Tipo: Artigo

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Outras publicacións en: Metas de enfermería

Resumo

Objective: to assess the safety and efficacy of the CONAN cure, taking into account the reduction in the number of leaks, the status of peristomal skin, and the quality of life perceived by the patient. Method: a prospective non-randomized study at national level, conducted in 54 Stomal Therapy Units, in order to evaluate the efficacy and safety of the CONAN cure, consisting in the use of the Easiflex® Confort Convex Light device and Brava® moldable rings during the early post-surgical stage in patients with digestive system ostomy with effluent leaks. The study intended to evaluate the effect of this strategy on leak reduction, to prevent peristomal skin deterioration, and to increase the wellbeing of patients at discharge. Statistical differences were compared between these variables, using the t-test, Squared-chi, McNemar and Bowker tests. Results: there was an evaluation of 257 patients, and 244 completed the study. With the CONAN cure, the number of leaks was reduced in 56% of patients, and the mean number of leaks moved from 3.4 ± 5.2 (V1) to 1.3 ± 2.3 (V2) (p< 0.0001); skin problems disappeared in 62% of patients who presented them, and the improvement in skin condition was highly evident. There was a change in the mean DET score from 3.3 ± 3.3 (V1) to 1.6 ± 2.3 (V2) (p< 0.0001). The mean satisfaction perceived by the patient increased from 5.1 ± 2 (V1) to 7.2 ± 1.7 (V2) (p< 0.0001). The proportion of patients with protruding stoma increased from 32.9% to 40% (p= 0.025). The majority of patients resumed their daily habits: 67% going for walks, 75% going out of their house, and 55% resting at night; 92% of participants wanted to continue using the Easiflex® Convex Light device. Conclusions: patients with digestive system ostomy and effluent leak during their early post-surgical period could clearly benefit of using the soft convex device (Easiflex® Confort Convex Light) with moldable ring (Brava®). The safety and efficacy of this approach was confirmed. There was a very high level of patient satisfaction with this treatment strategy, and a return to their daily habits was also confirmed.

Referencias bibliográficas

  • Claessens I, Probert R, Tielemans C, Steen A, Nilsson C, Dissing Andersen B, Størling ZM. The Ostomy Life Study: the everyday challenges faced by people living with a stoma in a snapshot. Gastrointest Nurs 2015; 13(5):18-25.
  • Rolstad BS, Erwin-Toth PL. Peristomal Skin Complications: Prevention and Management. Ostomy Wound Manage. 2004; 50(9):68-77.
  • Coloplast, Ostomy Life Study, 2014, Data on file (PM-15177).
  • Voegeli D, Karlsmark T, Eddes EH, Hansen HD, Zeeberg R, Håkan-Bloch J, Hedegaard CJ. Factors influencing the incidence of peristomal skin complications: evidence from a multinational survey on living with a stoma. Gastrointestinal Nurs. 2020; 18(S4):S31-S38.
  • Fellows J, Forest Lalande L, Martins L, Steen A, Størling ZM. Differences in Ostomy Pouch Seal Leakage Occurrences Between North American and European Residents. J Wound Ostomy Continence Nurs. 2017; 44(2):155-9.
  • Rodríguez González E, Del Pino Zurita C, Arrontes Caballero G, Hoyo Rodríguez A, Zapatero Rodríguez E, García Blázquez E. Factors predictive of optimal peristomal skin status in patients with an ostomy: a secondary analysis. Br J Community Nurs. 2021; a;26(Sup12):S24-S34.
  • Rock M, Kieserman JM, Sun V, Grant M, Ercolano E, McCorkle R, Holcomb MJ, Weinstein RS, Hornbrook MC, Krouse RS. Clinical and Demographic Differences Among Cancer Survivors With Ostomies With and Without Informal Caregivers. J Cancer Educ. 2022 Feb 3. Doi: http://doi.org/10.1007/s13187-022-02139-x
  • Ganjalikhani MK, Tirgari B, Rashtabadi OR, Shahesmaeili A. Studying the effect of structured ostomy care training on quality of life and anxiety of patients with permanent ostomy. Int Wound J. 2019; 16(6): 1383-90.
  • Kruse TM, Størling ZM. Considering the benefits of a new stoma appliance: a clinical trial. Br J Nurs. 2015; 24(22):S12, S14-8.
  • Rat P, Robert N, Fernandes I, Edmond D, Mauvais F. Evaluation of a one-piece soft convex ostomy appliance: a prospective, multicentre, open-label pilot study. Br J Nurs. 2018; 27(16):S20-S28.
  • Rodríguez González E, del Pino Zurita C, Arrontes Caballero G, Hoyo Rodríguez A, Zapatero Rodríguez E, García Blázquez E. Impact of convex ostomy appliances on leakage frequency, peristomal skin health and stomal protrusion. Gastrointest Nurs. 2021b; 19(Sup9):S30-S37. Doi: http://doi.org/10.12 968/gasn.2021.19.Sup9.S30
  • Jemec GB, Martins L, Claessens I, Ayello EA, Hansen AS, Poulsen LH, Sibbald RG. Assessing peristomal skin changes in ostomy patients: validation of the Ostomy Skin Tool. Br J Dermatol. 2011; 164(2):330-5.
  • Martins L, Ayello EA, Claessens I, Steen Hansen A, Hentze Poulsen L, Sibbald RG, Jemec GB. The ostomy skin tool: tracking peristomal skin changes. Br J Nurs. 2010; 19(15):960, 932-4.
  • Lado Teso A, Fabeiro Mouriño MJ, Bueno Cruz B, Vázquez García MC, Jiménez López I, Mera Soto A. Usos y actitudes de los pacientes ostomizados en España (Estudio U&A en Ostomía). Metas Enferm may 2019; 22(4):19-27.
  • Pieper B, Mikols C. Predischarge and postdischarge concerns of persons with an ostomy. J Wound Ostomy Continence Nurs. 1996; 23(2):105-9.
  • Butler DL. Early postoperative complications following ostomy surgery: a review. J Wound Ostomy Continence Nurs. 2009; 36(5):513-9.
  • Richbourg L, Thorpe JM, Rapp CG. Difficulties experienced by the ostomate after hospital discharge. J Wound Ostomy Continence Nurs. 2007; 34(1):70-9.
  • McPhail J, Nichols T, Menier M. A convex urostomy pouch with adhesive border: a patient survey. Br J Nurs. 2014; 23(22):1182-6.
  • Hoeflok J, Purnell P. Understanding the role of convex skin barriers in ostomy care. Nursing. 2017; 47(9):51-56.
  • McNichol L, Cobb T, Depaifve Y, Quigley M, Smitka K, Gray M. Characteristics of Convex Skin Barriers and Clinical Application: Results of an International Consensus Panel. J Wound Ostomy Continence Nurs. 2021; 48(6):524-32.
  • Hoeflok J, Guy D, Allen S, St-Cyr D. A prospective multicenter evaluation of a moldable stoma skin barrier. Ostomy Wound Manage. 2009; 55(5):62-9.
  • Szewczyk MT, Majewska G, Cabral MV, Hölzel-Piontek K. The effects of using a moldable skin barrier on peristomal skin condition in persons with an ostomy: results of a prospective, observational, multinational study. Ostomy Wound Manage. 2014; 60(12):16-26.
  • Liu G, Chen Y, Luo J, Liu A, Tang X. The Application of a Moldable Skin Barrier in the Self-Care of Elderly Ostomy Patients. Gastroenterol Nurs. 2017; 40(2): 117-20.
  • Hanley J. Convex stoma appliances: are we getting it right? Br J Nurs. 2013; 22(16):S3.
  • Lado Teso A, Del Pino C, Jiménez I, Lázaro M, Medina MM, García Blázquez E. Studying the effect of light convex appliance and adaptable rings in the early postoperative period of an intestinal ostomy with effluent leakage. Gastrointestinal Nurs. 2022 (en prensa).
  • Bueno Cruz B, Jiménez López I, Mera Soto A, Vázquez MC, Fabeiro Mouriño MJ, Lado Teso A, García Blázquez E. The effect of pre-operative stoma-site marking on peristomal skin health and quality of life. Gastrointestinal Nurs. 2021; 19(Sup4a):S2-S9.
  • Rodríguez González E, Del Pino Zurita C, Arrontes Caballero G, Hoyo Rodríguez A, Zapatero Rodríguez E, García Blázquez E. Factors predictive of optimal peristomal skin status in patients with an ostomy: a secondary analysis. Gastrointestinal Nurs. 2022; 20(Sup4):S34-S42.
Fonte de datos: Dialnet