WCET Journal - French Edition

Aim To compare the characteristics of patients with venous leg ulcers (VLU)s managed with low compression therapy in an acute care wound clinic at tertiary hospital setting versus those managed without compression in a community home care setting

Method This retrospective study reviewed medical records of VLU patients managed in the community home care setting and acute care wound clinic setting between January 2016 and December 2018. Characteristics of these patients receiving care of their VLUs in two different settings were evaluated. Data on patients’ medical history, demographics, and healing days were extracted from electronic records.

Results A total of 142 patient records were extracted and analysed, of which 73 were from the community home care and 69 from acute care wound clinic in a tertiary hospital. On average, patients had 1.48 ulcers (SD=0.85) from the community care and 1.59 (SD=0.84) from the acute care wound clinic. Factors such as ambulatory status, hypertension, diabetes mellitus, and anemia significantly affected VLU healing. Ulcer healing within 90 days was observed in 25 patients (34.2%) from community care, compared to seven patients (10.1%) from the acute care wound clinic.

Conclusion This study highlights differences in VLU patient profiles across care settings, suggesting that community patients managed without compression may have less complex needs. Further research including clinical factors like wound size and duration is needed to better guide treatment strategies.

Aim The aim of this survey was to ensure that the World Council of Enterostomal Therapists^® (WCET^®) International Ostomy Guideline (IOG) 3rd Edition considers stakeholder interest in the clinical questions posed.

Methods Ostomates, surgeons and nurses specialising in stoma care globally were surveyed on the importance of the clinical questions developed by the IOG-Guideline Development Panel (IOG-GDP). An online survey was distributed to committee members of the WCET^®, the International Society of University of Colon and Rectal Surgeons (ISUCRS) and the International Ostomy Association (IOA). The anonymous survey was available for four weeks online. Data on stakeholder demographics and their level of interest in 31 proposed clinical questions was collected. The level of interest in each question was measured using a 5-point Likert scale. Additional information was elicited by open-ended questions. Descriptive statistics were used to analyse answers to the Likert-style questions, and open-response questions were analysed by grouping responses in general themes.

Results Responses (n=103) were received from members of/aligned with ISUCRS (n=37) or 29 the WCET^® (n=29), people living with a stoma and/or an informal caregiver (n=10), and individuals not indicating an affiliation (n=27). Respondents expressed a high level of interest in all proposed questions. Level of positive interest in quality of life questions ranged from 97.96% to 87.38%. For individual’s knowledge, skills and self-care positive interest ranged from 88.35% to 93.20%; health professionals’ questions were all above 85%; preoperative care ranged from 88.35% to 94.18%; postoperative care ranged from 88.35% to 94.99%; products above 90%; ongoing/long-term care ranged from 85.44% to 93.2%. For questions on specific populations, the level of positive interest in religious/cultural considerations was 82.53%; populations with specific needs ranged from 76.70% for individuals at the end of live to 91.26% for individuals who are over/under weight or with obesity. Suggestions on additional topics and resources were generally unique.

Conclusion There is a high level of interest in the clinical questions developed by the IOG-GDP, indicating nurses, surgeons and individuals living with a stoma have very similar expectations about guideline content.

Peristomal skin complications (PSCs) are a major challenge for ostomy patients, affecting up to 73% and leading to significant physical, emotional, and financial burdens. PSCs commonly arise from medical adhesive-related skin injury (MARSI) and peristomal moisture-associated skin damage (PMASD), often due to unreliable barrier seals and exposure to alkaline stoma output. Despite advances in skin barrier technology, PSC rates remain high, highlighting the need for improved solutions.

This paper reviews the evolution of ostomy skin barriers, from early materials like karaya gum to modern hydrocolloid-based systems. It focuses on the Dansac TRE™ barrier, a next-generation solution featuring insoluble super-absorbing polymers (iSAP+) and pH-buffering technology. These innovations enable rapid fluid absorption, sustained pH stability, and enhanced erosion resistance, effectively reducing leakage and skin irritation. Clinical studies and case reports demonstrate that the iSAP+ barrier improves peristomal skin health, extends wear time, and decreases reliance on accessories and medications. Patients and clinicians report increased confidence, comfort, and independence, while economic analyses show reduced care costs.

The findings support the transformative potential of advanced barrier technologies in ostomy care, advocating for their broader adoption to standardise effective skin protection and improve patient outcomes. Future research should explore long-term results and person-centered care strategies to further optimise stoma management.

This case study aims to highlight an improvised and resource-conscious approach to managing severe surgical wound dehiscence complicated by secondary infection and temporary ileostomy formation following an iatrogenic bowel injury that occurred during a myomectomy. It also seeks to demonstrate how innovative wound management strategies were employed to both control and contain faecal output. These included the use of anti-motility medication (loperamide), stool-thickening foods and an Eakin fistula pouch. Together, these measures facilitated wound debridement and promoted spontaneous healing despite challenges, such as poor stoma siting and mucocutaneous separation in a low-resource setting.

Methods The principles of fistula management sepsis control, nutritional support, anatomy definition, and procedure planning (SNAP) were applied in managing this complex wound. A multidisciplinary team approach was implemented, involving surgeons, stoma care specialists, a clinical psychologist, ward nursing staff and nutritionists. Family members were actively engaged in decision-making and provided essential financial and emotional support. Additional management strategies focused on containing faecal output, promoting wound debridement, preventing infection and supporting spontaneous healing

Results The patient responded positively to the multidisciplinary plan of care within a low-resource clinical environment. Faecal output was effectively controlled and contained using an improvised fistula management technique, which minimised wound contamination and facilitated progressive debridement. Gradual development of healthy granulation tissue was observed, leading to spontaneous wound contraction and eventual closure without the need for further surgical intervention. The patient’s nutritional status and overall well-being improved significantly throughout the recovery period.