WCET Journal - Spanish Edition

Aim To examine how clinicians perceive peristomal skin health and define leakage, and to assess whether consideration of barrier formulation is associated with clinician confidence in leakage prevention and approaches to skin protection.

Methods A structured cross-sectional survey of 565 clinicians involved in ostomy care was conducted across multiple countries. The survey explored definitions of leakage, confidence in preventing leakage despite optimal fit and the role of barrier formulation in maintaining peristomal skin health. Data were analysed using descriptive statistics and exploratory cross-tabulation to identify patterns and associations.

Results Findings showed substantial variation in how clinicians define leakage. Overall, 51% defined leakage as any effluent under the barrier, 40% as effluent that compromises wear time or skin health, and 8% only when effluent escaped beyond the barrier. Despite optimal fit, 88% of clinicians reported they could not confidently say leakage would never occur. Although 56% reported always considering barrier formulation, 37% did so only sometimes. Clinicians who consistently considered formulation demonstrated greater confidence in leakage prevention, clearer definitions of leakage and a more proactive approach to peristomal skin health.

Conclusion Peristomal skin health cannot be defined by pouching system fit alone. Variation in leakage definitions and inconsistent integration of formulation into practice may hinder prevention-focused care. These findings support fit and formulation as complementary pillars of peristomal skin health and highlight the need for unified language, clinician education and evidence-based pathways to improve patient outcomes.

Introduction Diabetic foot ulcers (DFUs) are some of the most prevalent and debilitating complications among people with diabetes. A stronger support network is therefore required. Moreover, social support is positively associated with coping strategies for the disease and acts as a preventive factor for diabetic foot disease.

Objective To identify the benefits of social support participation in preventing DFUs.

Method This is an integrative review study carried out through searches in the following databases: PubMed, Embase, Scopus, Web of Science, Cochrane Library, LILACS, and SciElo. The controlled descriptors used were “Diabetic foot, Social support, and Prevention,” and in the international databases “Diabetic foot, Foot ulcer, Social support, and Prevention,” combined with the Boolean operators “AND” and “OR.”

Results It was found that social support in the prevention of diabetic foot enables better glycemic control, improvement in health-related quality of life, greater chances of preventing foot ulcers, and increased healing rates of DFUs.

Conclusion The role of social support in preventing diabetic foot ulcers has proven to be an effective way to help to modify factors that affect the development of diabetic foot disease and DFUs.

Aims Recent expert consensus supports the safe use of convexity at all stages post-ostomy, including immediately after surgery. Finite element analysis predicted interactions between geometric shapes in new soft convex technology and simulated stoma sites. This evaluation compared the clinical performance and user satisfaction of the novel soft convex ostomy system with existing products.

Methods A prospective convenience sample of patients with an ostomy in acute care or outpatient clinics across four US advanced specialty hospitals was evaluated between January 16 and June 14, 2024. Data were collected from wound ostomy continence nurse practitioners and registered nurses through an online survey managed by a certified research organisation, which also performed blinded data analysis.

Results Ninety evaluations were completed across four institutions. Most respondents were board certified wound ostomy continence nurses (99%), with 79% evaluating patients in acute care and 21% evaluating outpatients. The technology was assessed across a diverse patient population, with 49% ileostomies, 34% colostomies, and 17% urostomies. Most patients were in the immediate post-operative phase (57%), and 69% had complex peristomal skin contours. Clinical performance was rated highly: 96% reported wear time as “as expected” or “longer than expected,” and 89% strongly agreed that it created an effective seal. Flexibility and comfort were noted by 92%, while 91% agreed the convex design met clinical needs. Overall, 100% of respondents rated the product experience as good or excellent.

Conclusions The novel soft convex technology was found to be safe, effective and improved wear time in challenging clinical scenarios.

Objective To report on the experience of developing and validating Choosing Wisely^® recommendations for the treatment of infections in hard-to-heal wounds.

Method This is an experience report developed from a literature review, preparation of recommendations was based on the best evidence and validation by expert judges using the Delphi technique.

Results Five recommendations were developed on practices to be avoided in the treatment of these wounds. The process involved the participation of specialists from different regions of Brazil, generating unprecedented material for nursing and stoma therapy.

Conclusion The experience highlighted the relevance of a collaborative, evidence-based process to support safe, cost‑effective clinical practices aligned with the Choosing Wisely^® campaign.

Introduction Care coordination is essential in the management of complex wounds, requiring structured coordination and communication among services and professionals to adequately meet patient needs. This multidisciplinary approach is associated with morbidity, treatment costs and length of hospital stay.

Method: This is a descriptive case report conducted at a Cancer Center in São Paulo, Brazil.

Case report A 45-year-old male patient with no known comorbidities was diagnosed with rectal adenocarcinoma. He underwent robotic sphincter-preserving low anterior resection of the rectum with total mesorectal excision on 20 December 2022, followed by ileostomy closure on 18 April 2023. On 29 November 2023, he was readmitted with severe sepsis secondary to pelvic collection, low colorectal anastomotic dehiscence and necrotising fasciitis extending to the left lower limb. He underwent nine surgical debridements, negative pressure wound therapy, skin grafting, antimicrobial dressings, topical management of hypergranulation tissue and adjunctive low-level laser therapy. Care was coordinated by surgical, infectious disease, palliative care, nutrition, physiotherapy, psychology and the stomal therapy nursing team.

Conclusion: This case highlights the relevance of structured care coordination, specialist stomal therapy nursing involvement and individualised use of adjunctive wound therapies in the management of extensive complex wounds in oncology.

Delegates at the WCET™ Congress, in Vancouver, Canada in April, were treated to a very successful scientific programme with diverse, stimulating and high-quality content.

For the benefit of the many members who were unable to attend, here is a sample of poster presentations from around the world. A sample of oral presentations will appear in the December issue of the journal.