WCET Journal - Portuguese Edition

This paper reports the results of a global expert panel utilising a modified Delphi technique, to reach consensus on the use of mouldable ostomy technologies in ostomy practice. The aim of this document is to describe the current state-of-the science related to product selection in current ostomy practice. The objective of the project was to determine the best available evidence describing the use of mouldable stoma baseplate technologies in ostomy care compared to traditional cut-to-fit appliances. The rates of peristomal ostomy complications reported in the literature are unacceptable and reflect many factors such as lack of appropriate education, access to stoma care certified providers and the selection of appropriate ostomy products. The purpose of using the Delphi technique was to accomplish three specific objectives: 1) summarise the current state of mouldable ostomy technology knowledge, based on a scoping review of the literature; 2) formulate recommendations for clinical practice change in ostomy care; 3) consider expert experience to guide practice where published evidence could not be found. Six consensus statements with their aggregate level of evidence, risk of bias, and recommendations for clinical practice are presented herein.

The development of adenocarcinoma at an ileostomy site is an extremely uncommon and late complication that can occur for people living with a permanent ileostomy. Predominantly it is found in individuals who had their stoma surgery for ulcerative colitis, familial adenomatous polyposis or Crohn’s disease, at an average time of 27 years after the stoma was created. There have only been 70 reported cases in the literature worldwide, most of these in the last 20 years. The extended latent period for the adenocarcinoma to occur from time of stoma creation could help explain this increase in incidence. The exact cause of this malignancy is not clear but it has been suggested that factors such as chronic mechanical and chemical irritation from stoma appliances, disease predisposition, malignant transformation of adenomas, changes in bacterial flora and Ileitis/backwash ileitis, could contribute to their development.

Primary adenocarcinoma at an ileostomy has been reported in the literature by surgeons and medical practitioners. Despite this, there remains limited information on the care and management from key stakeholders such as stomal therapy nurses, when caring for a people living with a permanent ileostomy. This article provides a different understanding and description from the perspective of a stomal therapy nurse, describing two cases of primary adenocarcinoma at the ileostomy site.

Individuals living with ostomies in small communities rely on friends, family, and health-care professionals for support, otherwise, they risk becoming isolated, which may affect quality-of-life.

Objective This study explored how individuals and their partners manage ostomy care and engage in daily activities.

Method This study utilised semi-structured interviews to explore perspectives of six participants living with an ostomy and two care partners in eastern Canada. Participants were recruited through a hospital ostomy service and community libraries. Adults with ostomies and their partners willing to articulate the journey of living with a stoma were recruited. All data were analysed using reflexive thematic analysis.

Results Participants were challenged to receive consistent support from an ostomy nurse. Partners were not included in education sessions. Participants quickly adopted an independent self-management approach, were resilient and resourceful. Consistent connection to the ostomy clinics and accessible face-to-face or online supports were lacking. Participants searched web-based platform for support to manage complications.

Conclusion Nurses specialised in ostomy care are in a position to support adults living with ostomies, and their care partners. Consistent, relevant education and supports should be offered by interprofessional teams.

Delegates at the WCET^® Congress, in Glasgow, UK in September, 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 what was presented by speakers from around the world.