Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Jan 30;4(1):25-33.
doi: 10.23922/jarc.2019-032. eCollection 2020.

Current Management of Intestinal Stomas and Their Complications

Shingo Tsujinaka  1 , Kok-Yang Tan  2 , Yasuyuki Miyakura  1 , Rieko Fukano  3 , Mitsuko Oshima  3 , Fumio Konishi  4 , Toshiki Rikiyama  1
Affiliations
Review

Current Management of Intestinal Stomas and Their Complications

Shingo Tsujinaka et al. J Anus Rectum Colon. .

Abstract

Inappropriate stoma site, improper management of stoma, and stoma complications lead to diminished quality of life of ostomates. Healthcare professionals involved in stoma creation and/or care should have the fundamental and updated knowledge of the management of stomas and their complications. This review article consists of the following major sections: principles of perioperative patient management, early complications, and late complications. In the "principles of perioperative patient management" section, the current concepts and trends in preoperative education, stoma site marking, postoperative education, and patient educational resources are discussed. In the "early complications" section, we have focused on the etiology and current management of ischemia/necrosis, fluid and electrolyte imbalances, mucocutaneous separation, and retraction. In the "late complications" section, we have focused on the etiology and current management of parastomal hernia, stoma prolapse, parastomal varices, and pyoderma gangrenosum. Pre- and postoperative patient education facilitates the patient's independence in stoma care and resumption of normal activities. Healthcare providers should have basic skills and updated knowledge on the management of stomas and complications of stomas, to act as the first crisis manager for ostomates.

Keywords: Stoma complications; early complications; late complications; perioperative management; stoma care.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest There are no conflicts of interest.

Figures

Figure 1.
Figure 1.
Stoma necrosis above the fascia.
Figure 2.
Figure 2.
Stoma necrosis below the fascia.
Figure 3.
Figure 3.
Peristomal pyoderma gangrenosum (PPG) before treatment.
Figure 4.
Figure 4.
Application of alginate dressings to peristomal pyoderma gangrenosum (PPG).
Figure 5.
Figure 5.
Application of wafer-type skin barrier to peristomal pyoderma gangrenosum (PPG).
See this image and copyright information in PMC

References

    1. Wound, Ostomy and Continence Nurses Society; Guideline Development Task Force. WOCN Society Clinical Guideline: Management of the Adult Patient With a Fecal or Urinary Ostomy-An Executive Summary. J Wound Ostomy Continence Nurs. 2018 Jan/Feb; 45(1): 50-8. - PubMed
    1. Salvadalena G, Hendren S, McKenna L, et al. WOCN Society and ASCRS Position Statement on Preoperative Stoma Site Marking for Patients Undergoing Colostomy or Ileostomy Surgery. J Wound Ostomy Continence Nurs. 2015 May-Jun; 42(3): 249-52. - PubMed
    1. Husain SG, Cataldo TE. Late stomal complications. Clin Colon Rectal Surg. 2008 Feb; 21(1): 31-40. - PMC - PubMed
    1. Krishnamurty DM, Blatnik J, Mutch M. Stoma Complications. Clin Colon Rectal Surg. 2017 Jul; 30(3): 193-200. - PMC - PubMed
    1. Forsmo HM, Pfeffer F, Rasdal A, et al. Pre- and postoperative stoma education and guidance within an enhanced recovery after surgery (ERAS) programme reduces length of hospital stay in colorectal surgery. Int J Surg. 2016 Dec; 36(Pt A): 121-6. - PubMed