WCET Journal - Spanish Edition

Introduction The International Ostomy Guideline (IOG) developed by the World Council of Enterostomal Therapists (WCET^®) is currently being updated with the newest evidence to produce the third edition. The IOG presents clinical guidance to promote access to holistic stomal care, reduce stoma-associated complications, improve knowledge of health professionals regarding stomal care, and to optimise quality of life of individuals living with a stoma.

Methods The guideline development process is being undertaken by a Guideline Development Panel consisting of representatives of WCET^® and its collaborative partner, the International Society of University Colon and Rectal Surgery (ISUCRS). The development methods are underpinned by the Joanna Briggs Institute’s (JBI) theoretical framework of evidence-based care. The methodology embeds a rigorous process that includes generation of relevant clinical questions, evidence identification, critical appraisal of the research and use of adapted Evidence-to-Decision frameworks to reach evidence-based recommendations and good practice statements agreed on by an expert panel through a Delphi process. The methods include engagement from international stomal therapists, colorectal surgeons and individuals living with a stoma. The guideline development process addresses the key components of the JBI evidence-based model: global health, evidence generation, evidence synthesis, evidence transfer and evidence implementation.

Results The guideline will present evidence-based recommendations and good practice statements providing practical clinical guidance for the care of individuals who are to undergo, or who have undergone, ostomy surgery. Input from the WCET^® Executive Board, WCET^® Education Committee, Norma N Gill Foundation^® WCET^® International Delegates (IDs), the ISUCRS Education Committee, individuals living with an ostomy and broad stakeholder feedback will enhance the guideline recommendations.

Conclusion Developed using a rigorous methodology and with input from international experts and individuals living with a stoma, the WCET^® IOG third edition embraces the JBI aim of healthcare that is globally-relevant, feasible, appropriate, meaningful and effective.

Pouching systems play a key role in ostomy care. However, peristomal skin complications due to leaked effluent are a common problem. Mouldable skin barriers are an alternative to traditional cut-to-fit or precut barriers and may provide improved benefits for ostomates. We examined the best available evidence describing the use of mouldable stoma baseplate technologies in ostomy care. The objective was to determine the best evidence describing the differences between mouldable versus cut-to-fit products to inform healthcare providers, caregivers, and patients with ostomies about their recommended use. In this study, four subject matter experts (TB, JB, CM, LI) employed a PRISMA-P methodology utilising the Literature Review Network version 2.0 (LRN v2.0) for literature searches across PubMed, Embase, CINAHL, and Google Scholar. As an explainable artificial intelligence (XAI) system, the process and methods behind LRN’s decision making processes were explained in human terms. Researchers programmed the AI search based on study inclusion and exclusion criteria with iteration reports presented by recall percentage, precision and F-score. LRN’s outputs are explained for transparency in search iteration model accuracy, Cohen’s kappa and average potential. The human researchers then read all abstracts and full texts for final inclusion and analysis. Seventeen studies evaluating mouldable technology were identified. Key findings emerged in favor of the use of mouldable technology compared to cut-to-fit appliances regarding the following themes: overall satisfaction, reduced stoma complications, decreased nurse time to teach patient self-care, benefits over cut-to-fit stoma skin barriers, and costs with consistent outcomes demonstrated globally with diverse populations.

Skin tears are acute wounds which can affect individuals at the extremes of age. The prevalence of skin tears is as high if not higher than wounds such as pressure injuries. Skin tears can be associated with blunt trauma, mechanical forces and patient handling therefore preventative strategies should seek to address these factors. When a skin tear does occur there are several evidence-based steps that should be undertaken to optimise wound healing. This article provides a clinically focused, systematic approach for the principles and practice of skin tear management.