WCET Journal - Spanish Edition

Background Peristomal skin complications (PSCs) in the early post-operative period are commonly reported and considered largely preventable by many. Furthermore,  they affect overall wellbeing and quality of life (QoL). As part of a study investigating the number, type and aetiology of PSCs experienced by a cohort of Western Australian ostomates, a comprehensive literature review was conducted to establish the contributing factors associated with PSCs.

Method The primary literature search was conducted from January 2000 – September 2021 and the secondary search was conducted from September 2021 – June 2023. Papers published prior to 2000 were included if they were seminal works or there were no other recent publications on the topic.

Results Internationally peristomal skin complications were reported to be 6–80% and commonly occurred during the early to late post-operative periods. The literature identified contributing factors related to the ostomate such as; obesity, geographical location and access to stomal therapy nurse (STN) follow-up and those related to the stoma, to be the primary causes of PSCs. Comprehensive assessment of PSC risk factors, pre and post-operative stoma care education, regular post-operative follow-up and appropriate selection of appliances and accessories were found to be the most effective prevention strategies.

Discussion The aetiology of PSCs are multifactorial and all contributing factors need to be considered by stomal therapy nurses (STNs). The results were used to inform a risk assessment tool that can guide STNs to identify ostomates most at risk of PSCs. Such knowledge informs the implementation of prevention interventions which are anticipated to reduce the overall incidence of PSCs.

Background People who inject drugs (PWID) may be referred to emergency services for treatment of wound infections or skin and soft tissue infections (SSTIs), such as cellulitis, abscesses and sepsis.

Methods This qualitative study examined the perceptions and experiences of 20 adults who accessed emergency department/s (ED) for advanced wound treatment and antibiotics. Community-based participant interviews explored their experiences and perceptions of care. A thematic analysis was conducted.   

Results Findings characterise the perceptions and experiences of people with SSTIs in EDs, and include: early discussions with clinic physicians, nurses, family/friends who advised them to seek ED care; perceptions of being ‘less than’; stigmatisation; the perception of being blamed or having intentionally causing the wound; underassessed pain and withdrawal management; and the importance of ED staff education on pain and withdrawal management.

Discussion Participants described accessing community and ED services for their wounds in three provinces. They described reluctance to attend ED when advised and instead self-managed wound care. Participants outline suggestions for improving ED care, including improved prevention and education to better prepare teams to address pain management and withdrawal risk.

Aim/Hypothesis People living with an ostomy face physical, psychological, and social challenges that benefit from structured education pathways. While in-person education conducted by stomatherapists improves outcomes, ostomy-specific guidance for remote education is lacking. This study aims to develop a national, expert-validated set of indications specifying what to teach, how to deliver it remotely (including mixed pathways), and how to evaluate it.

Methods A modified Delphi, coupled with a consensus conference approach, will be conducted and reported via ACCORD. A heterogeneous national panel of stomatherapists with at least five years of professional experience and who have attended a 1500-hour specialisation course in stoma care; and expert patients, identified through the Italian National Federation of the Association of Incontinence and Ostomy Patients, will be recruited. Round 1 will be a 90-minute online focus group discussion to refine literature-derived indications and key definitions. Subsequent rounds, based on online surveys, will rate statements on a 4-point scale, allowing for free-text comments and controlled feedback. Consensus is defined as ≥75% agreement, with a target of ≥70% response rates between rounds. Quantitative data will be analysed for percentages and rates; qualitative comments will guide iterative revision.

Results Outputs will include core educational content; criteria distinguishing face-to-face, remote, and mixed pathways; and minimum standards for equity, privacy, consent and data protection.

Conclusion The study will deliver the first national consensus of experts for remote ostomy education, offering a practical, person-centered, secure blueprint for routine services and a shared outcome set for quality improvement.

Aim To assess Quality of Life (QoL) among adult stoma patients and problems faced by them during the COVID-19 pandemic.

Methods In this descriptive cross-sectional study 100 adult stoma patients visiting a stoma clinic and ostomy society office in a tertiary health care centre in India were enrolled through purposive sampling. Demographic data and QoL of stoma patients were collected through interviewing the patients using City of Hope – Quality of Life Ostomy Questionnaire. Problems faced by stoma patients were assessed through a pre-validated and tested self-developed structured tool (reliability coefficient=0.825).

Results The study findings revealed that a majority (27%) of the stoma patients had poor QoL, with mean overall QoL scores of 3.64±0.46. The lowest QoL scores were in the social domain. There were several problems faced by stoma patients during COVID-19, including leakage and peristomal skin problems (98%), problems with accessing professional help (87%), financial burdens (95%) and being unable to meet ostomy society members (100%). Significant associations were present between QoL and problems due to the location of their stoma, changes in clothing and adjusting diets due to ostomy (p value=<0.05). There was moderate negative correlation between QoL and financial and mental problems faced by stoma patients during the COVID-19 pandemic with  p value <0.01.

Conclusion The majority of the stoma patients had poor QoL during the COVID-19 pandemic. There were several problems faced by stoma patients, including physical, financial, social and psychological problems.

Introduction The Prevention Guide for Leakage and Peristomal Skin Complications (PSCs) aims to advance holistic and structured preventive strategies in the management of leakage and PSCs. The Prevention Guide builds on the well-established Risk Factor Model for leakage and PSCs to provide a clinical tool linking systematic identification of risk factors to potential consequences and actionable mitigating interventions for the healthcare professionals (HCP) to consider.

Aim To translate the Risk Factor Model into a practical Prevention Guide for leakage and PSCs and evaluate the resulting tools, the bedside tool and the supporting learning resources, for clinical use.

Methods Through close collaboration with experienced stoma care nurses and clinical stoma care experts, the Prevention Guide was developed into an interactive PDF (iPDF) bedside tool, and supporting learning resources for e-learning, and a library of bite-sized videos. Quantitative pilot testing by stoma care nurses and qualitative reviews by clinical stoma care experts assessed the relevance and effectiveness of the Prevention Guide tools.

Results The Prevention Guide iPDF can be used as a decision-support tool in routine stoma care. The e-learning materials provide engaging structured modules that support the learner to implement a preventive approach. The video library features clear and concise bite-sized video explainers to be used for training, or for quickly brushing up on relevant knowledge regarding particular risk factors.

Conclusion All three tools have been evaluated by SCNs and were identified as useful tools for facilitating systematic patient assessment, enhancing documentation and providing an educational resource. Overall, the Prevention Guide helps to apply a systematic approach, linking problem identification for leakage and PSCs with corresponding targeted interventions.

Introduction Convex ostomy baseplates are designed to help minimise the risk of leakage and support the maintenance of peristomal skin health. Their performance is defined by five key characteristics: depth, slope, tension location, compressibility and flexibility. The adhesive component further plays a role in ensuring a secure and comfortable seal.

Aim The aim is to translate technical parameters that define convexity into practical clinical guidance, illustrating how these characteristics inform product selection and support optimal patient outcomes.

Methods This article synthesises current evidence and definitions of convexity parameters and integrates them with clinical reflections from two experienced stoma care nurses. Two real-world clinical cases are presented to demonstrate the practical application of convexity principles in postoperative stoma management.

Results Across the two cases, clinicians applied the five convexity parameters together with adhesive considerations to address challenges such as uneven abdominal contours, firm or bending abdominal walls, peristomal folds, mucocutaneous dehiscence and risks of leakage. In both scenarios, tailored convex product selection supported secure sealing and protected peristomal skin.

Conclusion Understanding the clinical relevance of convexity characteristics and adhesive performance is essential for effective product selection in stoma care. Individualised product selection based on patient-specific needs enables clinicians to optimise fit, maintain peristomal skin health and improve clinical outcomes.

Aims To investigate effects of SenSura Mio Convex Soft on stoma-leakage and leakage-related quality of life (QoL).

Methods The study was an interventional, single-arm, open-label, multicentre trial conducted in Great Britain, the Netherlands, Norway and USA. The sample comprised individuals with leakage-issues when using flat baseplates. Participants used their own flat pouching system in a 2-week baseline period and subsequently SenSura Mio Convex Soft for 12 weeks. The primary endpoint was leakage area underneath the baseplate-adhesive. Secondary outcomes were leakage incidents outside the baseplate and leakage-related QoL using the validated Ostomy Leak Impact (OLI) tool, which consists of three domains capturing the impact of leakage on emotional aspects, engagement in usual and social activities and ability to cope and being in control. Primary comparisons between 12-week data with SenSura Mio Convex Soft and baseline flat baseplates were evaluated using mixed repeated measures models and a logistic regression model for correlated data.

Results Statistical analyses included 74 participants (Intention-to-treat population). After 12 weeks, use of SenSura Mio Convex Soft resulted in less leakage underneath the baseplate-adhesive than with flat pouching systems (estimated mean difference=−2.4 cm squared; P=0.001). Participants experienced fewer incidents of leakage outside the baseplate when using SenSura Mio Convex Soft (with 2.2% of the baseplates) versus flat pouching systems (7.0%) (P<0.001). Participants also reported significant improvements in all three domains of the OLI tool. Adverse events were comparable between the baseline and intervention periods, mainly affecting the peristomal skin.

Conclusions Study findings indicate that using SenSura Mio Convex Soft resulted in less leakage underneath the baseplate, fewer soiling incidents and higher leakage-related QoL compared to using flat pouching systems.

The study was registered on ClinicalTrials.gov (ID-NR: NCT02517541).