Early Peristomal Skin Complications Reported by WOC Nurses

Abstract

Purpose: The range of peristomal skin complications reported in the literature varies from 10% to 70%. Inconsistent terminology as well as a lack of a standardized tracking tool may account for this variability. The purpose of this study was to describe peristomal skin complications seen by WOC nurses over a 1-year period using a standardized data collection tool and using the peristomal terminology developed by the WOCN Society.

Methods: A prospective research design was used to describe peristomal skin complications of ostomy patients seen within the first 2 months of ostomy surgery by WOC Central Virginia Affiliate nurses. The WOC nurses completed a peristomal skin complication form on each ostomy patient that was seen within 2 months of the original ostomy surgery regardless of whether or not he or she had a peristomal complication. Descriptive statistics were used to summarize data.

Subjects and setting: Twelve WOC nurses saw a total of 89 patients over a 12-month period. Subjects had a median age of 61 years (range, 1-91 years). The sample included 46 females and 43 males. All patients were seen in the central Virginia area. Thirty-two patients were seen in hospital, 31 were seen in a home health setting, and 26 were seen in outpatient clinic.

Results: Forty-two patients (47%) had peristomal complications. The types of ostomies seen were 37 colostomies, 33 ileostomies, and 15 urinary conduits. Thirty-one patients had chemical damage to the peristomal skin (irritant dermatitis), 5 had mechanical injury, and 4 had Candida infections, 1 had an allergic reaction, and another had pyoderma gangrenosum.

Conclusions: Research studies that describe peristomal skin complications over time and over multiple settings are limited. A central data repository using a standardized tool may be one way to monitor them and then begin to look at standardized evidence-based peristomal skin care.