Ostomy Bag Research Articles

Abstract B081: Caring for the Caregivers: Characteristics and challenges faced by caregivers of Latino Californians with rectal cancer

Abstract Background/Purpose: Caregivers often face physical, psychological, and financial burdens when caring for people with cancer. Caregivers of Hispanic/Latino (HL) patients with cancer are often informal caregivers, such as families and friends, reflecting the traditional cultural value of familismo. While many studies acknowledge the impact of cultural differences on caregiving and caregiver burden, our understanding of the specific barriers HL patients with rectal cancer and their caregivers encounter is limited. The aim of this study was to explore the unique challenges, experiences, and perspectives of individuals caring for HL patients with rectal cancer in ways that could inform future interventions. Methods/Study population: We conducted semi-structured interviews of Bay Area and San Joaquin Valley HL patients with past or current rectal cancer in English and/or Spanish based on participant preference. We partnered with Visión y Compromiso, a promotores and community health worker organization, and developed a community advisory board to help refine our interview guide and interpret our results. We encouraged patients to identify and include someone who helped care for them during their treatment, but intentionally did not define caregiver in any other way. Over six months, we interviewed a total of 17 patients and eight caregivers and used reflexive thematic analysis to identify themes from their shared experiences using interview transcripts in NVivo 14. Results: Sixteen of seventeen interviews identified family members including spouses, sons, brothers, and friends as primary caregivers. Identified themes include (1) roles informal caregivers undertake for transportation, daily activities, and healthcare management; (2) limitations in utilizing social workers as a resource due to a knowledge gap and language barriers; (3) personal financial burden from supporting patients and navigating through available resources, and (4) psychosocial impacts resulting from role overload as an advocate, a translator, and a caregiver. Conclusion: In supporting cancer patients, caregivers wear many hats. While many caregivers share similar burdens, informal caregivers experience added emotional stress from unexpectedly assuming new responsibilities. Specific to rectal cancer care, caregivers are often tasked with aiding in ostomy bag changes and navigating the multidisciplinary treatment teams. Furthermore, HL patients and their caregivers face unique challenges due to language barriers, such as the burden of translation and delivering news. Understanding the caregiver burden among HL patients with rectal cancer is crucial in enhancing cancer treatment and care, creating culturally relevant resources, and reducing cancer outcome disparities faced by HL communities. Citation Format: Min Young Kim, Julian P. Howland, Eleanor Brown, Lucas K. Carpenter, Patricia Castañeda, Maria Gonzalez, Miriam T. Hernandez, Zaria N. Cosby, Kristen M. Davis-Lopez, Ysabel Duron, Gladys M. Rodriguez, Sandra S. Zaky, Arden M. Morris, Aaron J. Dawes. Caring for the Caregivers: Characteristics and challenges faced by caregivers of Latino Californians with rectal cancer [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B081.

A Study of Patient Concerns in the Modern Therapeutic Era of Inflammatory Bowel Disease.

Patient concerns and preferences are important in the management of inflammatory bowel disease (IBD: Crohn's disease [CD], ulcerative colitis). In the absence of contemporary data, we aimed to determine patient concerns and preferences and establish if there are demographic or disease-related differences. We surveyed patients with IBD at Massachusetts General Hospital between July and September 2023. The Rating Form of Inflammatory Bowel Disease Patient Concerns (RFIPC) and a set of supplemental questions rated on a visual analog scale (0-100mm) were administered to patients and compared by age, disease type, sex, and surgery status. Additionally, a survey administered to treating providers gathered insight into the difference between patient and provider perceptions of concerns. A total of 350 patients and 30 providers completed the survey. The mean age was 47 years; 50% were female, 49% had CD, and 80% were on advanced IBD therapy. Effects of medication (median = 54), energy level (median = 53), and having an ostomy bag (median = 52) were rated highest by patients. Older patients rated most disease complication and treatment-related concerns similar to younger adults; those aged 35-59 years had the greatest level of concern for most questions. Sex, disease activity, and prior surgical history also impacted patients' concerns. Providers perceived patients' worries as higher than those rated by patients themselves. A shared decision-making model targeting the achievement of disease remission and addressing concerns rated highly by patients is important to meet the goal of care for patients with IBD.

3D printing and intelligent technology increase convenience, reliability, and patient acceptance of ostomy nursing: a randomized controlled trial.

Traditional ostomy bags commonly cause skin allergy and inflammation around the stoma, as well as leakage. This study aimed to examine the effect of a 3D-printed ostomy bag with sensors and stimulators on stoma nursing. This is a randomized controlled trial. This trial involved 113 distinct individuals who undergo colorectal cancer surgery and intestinal obstruction surgery, with resulting stoma. The date of trial registration was January 17, 2019, and the date of first recruitment was May 1, 2019. Patients were randomized into two groups: intelligent 3D-printed ostomy bag (3D group, n = 57) and Coloplast one-piece pouching systems (control group, n = 56). The shape of ostomy and the surrounding skin of all the 57 patients of the 3D group was scanned by a handheld 3D scanner. Then, the ostomy bag chassis (also known as skin barrier) was 3D printed and an intelligent device adhered to the ostomy bag. The wearing time, leakage rate, the Discoloration, Erosion, and Tissue Overgrowth (DET) score, and the Acceptance of Illness Scale (AIS) were observed. In the 3D-printed bag group, the time to wear (0.7 ± 0.4m) was significantly shorter than that of the control group (9.1 ± 3.5m). The leakage rate of 3D-printed bag (1.75%) was significantly lower than that of the control group (16.1%). The DET score for the 3D-printed bag group was also lower than that of the control group, and the AIS score for the 3D-printed bag group was higher than that of the control group. The 3D-printed ostomy bags and the linked computer program can significantly reduce wearing time, leakage rate, and stoma complications. This may improve the quality of home ostomy care for patients and reduce the incidence of skin complications around the stoma.Registration number: ChiCTR1900020752.

Risk Factors Analysis and Pathogen Distribution of Urinary Tract Infection in Patients Undergoing Cutaneous Ureterostomy After Radical Cystectomy for Bladder Cancer.

Postoperative urinary tract infection is a common complication that not only significantly prolongs the hospital stay and amplifies the economic burden on patients, but also affects their quality of life and prognosis. This study aimed to investigate risk factors and distribution of pathogenic bacteria in urinary tract infections among bladder cancer patients who underwent cutaneous ureterostomy following radical cystectomy. A total of 137 bladder cancer patients, who underwent cutaneous ureterostomy after radical cystectomy at our hospital from November 2018 to October 2022, were enrolled in this retrospective study. Univariate and multivariate logistic regression analyses were employed to investigate the risk factors associated with postoperative urinary tract infection and the distribution of pathogenic bacteria among the infected patients. The results of both univariate and multivariate analyses confirmed that age, proficiency in ostomy knowledge, frequency of ureteral stent tube replacement, ureteral stent tube dislodgement, urine immersion at the outer end of the ureteral stent tube, and the interval of ostomy bag replacement were independent risk factors for urinary tract infection after radical cystectomy and cutaneous ureterostomy in bladder cancer patients. A total of 55 pathogenic bacteria were isolated from 52 patients with infections. Predominantly, these were gram-negative bacteria (34 strains, 61.8%), with Proteus mirabilis having the highest proportion. Urinary tract infections after radical cystectomy and cutaneous ureterostomy predominantly involve gram-negative bacteria. This is correlated with factors such as the age of bladder cancer patients, the level of nursing education, the duration of ureteral stent tubes and ostomy bag usage, as well as issues related to impaired urine drainage.

Observing the Effects of Applying a Modified Ostomy Bag in Postoperative Colorectal Cancer Patients with an Ostomy

Objectives: In this study, we investigated the influence of improved stoma bags on postoperative indicators in patients undergoing stoma surgery for colon cancer. Methods: A total of 100 patients who underwent surgical treatment for colon cancer were selected as research participants. They were randomly divided into an observation group of 51 cases and a control group of 49 cases using a blind method. The observation group received modified protective colostomy bags, and the control group received conventional stoma bags. We compared surgical indicators, complications, adaptation levels, and serum gastrin (GAS) levels between the 2 groups. Results: After surgery, the observation group had significantly shorter fasting time, hospital stay, and time to pass flatus compared to the control group (p < .05). The observation group also had a lower incidence of postoperative complications compared to the control group, with statistically significant differences (p < .05). Furthermore, the observation group had higher stoma adaptation level scores compared to the control group, with statistically significant differences (p < .05). Additionally, the GAS levels in the observation group were significantly lower than in the control group after surgery (p < .05). Conclusion: The modified surgery for stoma bag placement is characterized by its simplicity and cost-effectiveness. Patients can learn quickly how to use it, which helps them overcome psychological barriers, reduce anxiety, promote postoperative recovery, and improve their quality of life.

Adapting to the burdens of care: a telehealth program for cancer survivors with ostomies.

An ostomy introduces to cancer survivors new demands for self-care and healthcare resource use. A curriculum that teaches ostomates self-management skills may affect survivors' use of resources. A prospective randomized trial comparing usual care (UC) with an Ostomy Self-Management Training (OSMT) program delivered by telehealth was conducted in patients with ostomies due to cancer. The intervention occurred over 5weeks with survey administration at baseline, program completion, and 6months after completion. Quantitative data were analyzed using a mixed-effects logistic model to predict mean values of resource and service use. Responses to the open-ended question were coded and analyzed with directed content analysis. One hundred and sixty-seven subjects (89 in the OSMT arm and 78 in the UC arm) completed the questionnaire at all time points. The changes in likelihoods of emptying one's ostomy bag > 8 times/week and of incurring any out-of-pocket costs on accessories were 14% greater for the intervention group (p = .029 and p = .063, respectively). Qualitative analysis reveals among the OSMT arm an increase in the proportion of ostomy-specific comments and a decrease in the same metric among the UC arm. Common themes included learning to work with equipment, dealing with gas build-up and finding well-fitting clothing. There are some indications that participants in this structured telehealth program are more active in ostomy self-care. The reported ostomy self-care activities, healthcare consumables, and healthcare services reported by both groups illustrate the complexity of survivorship care following ostomy surgery. National Clinical Trial Identifier: NCT02974634.

Ostomy Bag and Betel Leaf in Pediatric Stoma Care

Background: Construction of a stoma is a common procedure in pediatric surgical practice. For care of these stomas, commercially available devices such as Ostomy bag, either disposable or of longer duration are usually used. These are expensive, particularly in countries like Bangladesh, and proper-sized ones are not always available. We have found an alternative for stoma care, betel leaf, which is suitable for Bangladeshis. Objective: The main objective of this study was to compare between Ostomy bag and betel leaf in Pediatric stoma care and also comparison of skin excoriation between Ostomy bag and betel leaf using in pediatric stoma care & comparison of cost and care givers satisfaction of the study groups. Materials and Methods: A total of 60 patients having various types of stoma within the age of 12 years were included in the study and randomly assigned to 2 groups – group 1 with Ostomy bag (30 patients) and group 2 with Betel leaf (30 patients). After construction of stoma, at first zinc oxide paste was applied on the Peristomal skin. A betel leaf with shiny, smooth surface outwards & rough surface inwards was put over the stoma with a hole made in the center according to the size of stoma. Another intact leaf covers the stomal opening. When bowel movement occurs, the overlying intact leaf was removed & the faecal matter was washed away from both. The leaves were reused after cleaning. Use of commercially available Ostomy bag (e.g., Convatec ostomy bag) with Adhesive paste (Stomahesive) will be applied on the Peristomal skin. Results: Out of 60 pediatric patients, 20 had pelvic colostomy, 19 had transverse colostomy and 21 had ileostomy. Of 60 patients under stoma care Mild excoriation had seen 21.7% cases of ostomy bag group and 13.3% cases of betel leaf group. Only 5% cases of ostomy bag group had moderate excoriation (P value was 0.116 which was not significant).Out of 40% excoriation, 30% occurred in ileostomy (p value <0.0001, hence significant). .....

Novel Use of a Vascular Closure Device for Treatment of an Enterocutaneous Fistula

A 78-year-old man with a history of numerous abdominal surgeries presented with a persistently draining (20 mL/day) enterocutaneous fistula 3 months after the removal of a 6-year-old jejunostomy catheter (Fig 1a). Closure was attempted with a topical skin adhesive; however, the site continued to leak, ultimately requiring an ostomy bag. The patient was deemed a poor surgical candidate because of a suspected large number of adhesions.

S2753 Nodular Regenerative Hyperplasia-Induced Peristomal Variceal Bleeding: A Rare Thiopurine Side Effect

Introduction: Azathioprine (AZA) and 6-Mercaptopurine (6-MP) are agents used to treat Inflammatory Bowel Disease (IBD). One of the rare side-effects described in cases throughout the literature is the development of Nodular Regenerative Hyperplasia (NRH) of the liver. NRH can lead to the development of non-cirrhotic portal hypertension (NCPH) which can then progress to ascites and varices. We present a patient who developed NRH from long-standing 6MP leading to peristomal variceal bleeding. Case Description/Methods: This case involves a 12 y/o male with fistulizing and stricturing Crohn’s disease, who was on 6-MP monotherapy from ages 14-18 and then restarted at age 27. At age 29, he underwent a partial colectomy with colostomy creation. Subsequently, he began to experience blood in his ostomy bag, which was later identified to be due to peristomal varices. Abdominal CT revealed lower esophageal varices and a nodular appearing liver. Liver biopsy then confirmed NRH, which had progressed to NCPH, and ultimately bleeding peristomal varices. The patient underwent a successful TIPS procedure with resolution of the varices and has not had any further bleeding. (Figure) Discussion: While there are a few cases of esophageal and gastric variceal bleeding due to NCPH secondary to thiopurine induced NRH, a case of peristomal variceal bleeding has yet to be described. NRH is a poorly understood condition that is characterized by diffuse transformation of normal liver parenchyma into small regenerative nodules with little to no fibrosis. Increased liver nodularity can cause NCPH and subsequently formation of varices throughout the GI tract. Patients with IBD on thiopurines have a cumulative incidence of NRH of 0.6% and 1.28% at 5 and 10 years, respectively1. NRH has a variable clinical presentation- from asymptomatic to severe complications of NCPH--and patients often do not present until late in the disease course. Several risk factors associated with development of NRH are male sex, stricturing and/or fistulizing disease, and history of a bowel resection. While NRH and its pursuing complications from thiopurines remains a rare entity, clinicians should be cognizant of this potential complication--particularly in those with fistulizing/stricturing disease and/or a surgical resection with an ostomy who present with gastrointestinal bleeding.Figure 1.: A – Digital subtraction angiographic (DSA) image shows catheter-directed venography of a dilated branch of the inferior mesenteric vein (IMV) that supplies a network of peristomal varices (black arrow). B - After successful creation of a transjugular intrahepatic portosystemic shunt (TIPS) with a covered stent (white arrow), a DSA image shows a plug and foam (black arrow) in the dilated IMV branch with decreased blood flow into the peristomal varices. C- Final DSA image of completion IMV venography shows absent blood flow into the dilated IMV branch and peristomal varices.

S2912 Transjugular Intrahepatic Portosystemic Shunt as a Cure for Macrohematuria

Introduction: Varices most commonly form in the esophagus or stomach, however, they can form anywhere along the gastrointestinal tract. Ostomy-related varices can be challenging to diagnose and treat. Here, we discuss a rare case of recurrent bleeding from an ileal conduit urostomy due to ectopic varices successfully treated with a transjugular intrahepatic portosystemic shunt (TIPS). Case Description/Methods: A-59-year-old male with a history of ileal conduit due to spina bifida complicated by neurogenic bladder, and alcoholic cirrhosis presented with a 3-weeks of recurrent bleeding from the urostomy site. The patient presented three times with bleeding from his urostomy site. Each time he received a blood transfusion and was seen by urology, and was subsequently treated with silver nitrate, cauterization, and suturing. The bleeding would stop temporarily and then recur. He eventually presented with reports of “fist-sized” blood clots pouring into his ostomy bag. Sutures were placed to tamponade the bleeding by Urology. Physical exam was significant for hypotension and palor. Laboratory tests were significant for hemoglobin of 6.0 g/dl. Gastroenterology was consulted and bleeding was thought to be due to ectopic variceal hemorrhage at the stoma site. TIPS was performed by Interventional Radiology. During the procedure, it was noted that there were tortuous dilated peristomal varices in the distal superior mesenteric vein corresponding to the ileal conduit, which were subsequently sclerosed and embolized (Figure 1). The patient was monitored for 48 hours after the procedure. On follow-up after 2 months, he continued to do well and without recurrence of bleeding. Discussion: Hemorrhage from stomal varices is a rare but serious complication of portal hypertension. While the bleeding sometimes may be limited to one area and thus respond to manual compression, more commonly, the bleeding is diffuse and requires further intervention. There are a few treatment modalities that can be explored in these cases including decompression with TIPS, endoscopic band ligation, endoscopic sclerotherapy, glue injection, or surgery. Decompression with TIPS carries a lower rate of complication and re-bleeding rate compared to other lines of management. Our patient underwent TIPS which resulted in the cessation of bleeding without complications.Figure 1.: TIPS placement with reduction of portosystemic gradient from 21 mmHg to 5 mmHg. Tortuous dilated peristomal varices are seen in the distal superior mesenteric vein at the level of the ileal conduit. Sclerosis and embolization of the peristomal varices were performed.

Translation and evaluation of the simplified Chinese version of the rating form of IBD patient concerns

BackgroundInflammatory bowel disease (IBD) has become a global public health problem. The prevalence of IBD in China increased annually in past two decades.MethodsThis study was to translate and validate the rating form of IBD patients' concerns (RFIPC), and to describe disease-related worries and concerns of patients with IBD. The simplified Chinese version of the RFIPC was developed according to translation and back-translation procedure. Patients with IBD were consecutively enrolled from the First Affiliated Hospital of Guangzhou University of Chinese Medicine. The participants were assessed using the RFIPC and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ). Internal consistency, test–retest reliability, measurement error, confirmatory factor analysis (CFA) and correlation of the RFIPC with the SIBDQ were performed to evaluate the psychometric characteristics of the RFIPC.ResultsA total of 116 patients with IBD, 73 with ulcerative colitis (UC) and 43 with Crohn’s disease (CD), were enrolled in this study. Thirty-seven of them recompleted the questionnaires for the second time between 7 and 14 days after the first interview. The results of CFA indicated the original structure of the RFIPC was reasonable. Cronbach's alpha value of the RFIPC were 0.97. The intraclass correlation coefficients of four domains ranged from 0.85 to 0.92. The standard error of measurement was 7.10. The correlation coefficients between total score of the RFIPC and the SIBDQ score ranged from − 0.54 to − 0.70. Median total score of the RFIPC was 39.4 (IQR 24.0–59.3). Patients with severe symptoms reported higher scores of the RFIPC. The uncertain nature of disease, having surgery, having an ostomy bag, developing cancer, feeling out of control, being a burden on others and financial difficulties were highest concerns of patients with IBD. Comparing with patients with UC, patients with CD had more concerns of the ability to have children and being treated as different (P < 0.05).ConclusionsThe simplified Chinese version of RFIPC is a valid and reliable tool. It could be used for assessing disease-related worries and concerns of patients with IBD in China. Specific concerns of patients with UC and CD are different, therefore, health workers should consider the specific needs of UC and CD patients.

Effect of Eight Different Methods for Preventing Incontinence-associated Dermatitis: A Network Meta-analysis

The objective is to systematically evaluate the effects of different methods in the prevention of incontinence-associated dermatitis. Methods is based on Searched PubMed, the Cochrane Library, Web of Science, EMbase, CNKI, VIP and CBM,and the search time limit was all built until January 2019.Two investigators independently screened the literature, extracted the data and evaluated the risk of bias in the included studies. The R 3.5.2 software gemtc package, JAGS 4.3.0, and Stata 13.0 software were used for analysis. Results: A total of 24 articles were included and 2367 patients were included. Mesh meta-analysis results show that the skin protective agent, ostomy bag combined drainage device, ostomy bag, ostomy bag combined with skin protectant, built-in tampon to prevent the incidence of incontinence-related dermatitis is better than conventional care; The effect of devices and ostomy bags on preventing the incidence of incontinence-associated dermatitis is better than that of drainage devices and built-in tampon; the effect of ostomy pouch combined with skin protectant on preventing the incidence of incontinence-associated dermatitis is better than that of built-in tampon. The ranking probability map shows that the ostomy combined drainage device is a better solution to prevent the incidence of incontinence-associated dermatitis. Conclusion: According to the results of mesh meta-analysis and probabilistic ranking, the effect of the laparoscopic combined drainage device bag on preventing the incidence of incontinence-associated dermatitis is better than other methods. Future research should also be focused on the direct comparison of effects between different methods and the evaluation of cost effectiveness.

Disease activity, burden and suffering in patients with ulcerative colitis in the UK cohort recruited into the global ICONIC study

ObjectiveThe Understanding the Impact of Ulcerative Colitis and Its Associated Disease Burden on Patients (ICONIC) was a 2-year, global, prospective, observational study assessing disease burden in adults recently diagnosed (≤36...

Early Diagnosis of Necrotizing Enterocolitis in Neonates Using an Electronic Nose

Background: Necrotizing enterocolitis (NEC) is a devastating clinical problem that often necessitates resection of necrotic intestine, leaving infants with a suboptimal length of intestine to absorb nutrition. There are no adequate tests or biomarkers to predict NEC onset. We hypothesized that assessment of biological samples with a novel electronic nose can be used with machine learning algorithms to detect aberrancies in stool and urine volatile organic compounds to predict NEC risk. &#x0D; Methods: 18 infants of gestational age ≤34 weeks in the Riley Hospital NICU were enrolled in the study and underwent stool (38 control, 3 NEC) and urine (42 control, 5 NEC) sample collection. Stool was collected by the bedside nurse via the infant’s diaper or ostomy bag. Urine was collected using a bag around the infant’s perineum or via foley catheter if already present. Stool samples and 250uL urine samples were aliquoted into Eppendorf tubes and covered with Parafilm. Samples were heated to 40°C, 30 minutes for stool, and 10 minutes for urine. Sample headspace was analyzed using the Cyranose 320 electronic nose, creating a “smellprint” comprised of readings from 32 unique sensors. Individual sensors were compared using Mann-Whitney U test. P&lt;0.05 was significant. &#x0D; Results: There was no significant difference in urine or stool signals among the 32 sensors between NEC and control groups. &#x0D; Potential Impact: While no significant difference was found, this study is greatly limited by the number of patients enrolled, with only 2 of the 18 being diagnosed with NEC. Past retrospective studies with this device have found differences between NEC and non-NEC stool. The future goals of this study are to continue enrolling patients to have a more robust data set. Using machine learning, we aim to create a model to predict NEC before its clinical manifestation so that beneficial treatment can be initiated earlier. &#x0D; &#x0D; Acknowledgment: This project was funded, in part, with support from the NIH NHLBI Short-Term Training Program in Biomedical Sciences Grant funded, in part by T35HL110854 from the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Design of experiment for optimization of 3D printing parameters of base plate structures in colostomy bag for newborns

ABSTRACT This study introduces a low-cost ostomy bag with sufficient softness for a newborn’s body to improve newborn medical care. Fused-deposition modeling was performed with a thermoplastic elastomer as the 3D printing material. The experimental design of the Taguchi L9(34) orthogonal arrays was used for the parameter design. To assess quality, the hardness was measured, with a focus on the smaller-the-better characteristic of the average hardness. The experimental results showed that the optimal combination of the structural hardness parameters is A1B3C1D1. As per the A scale, the average Shore hardness of the experimental model was 41.9. The signal-to-noise ratio of the experimental sample was −32.4526 dB, which is within the confidence interval, indicating that the factor effect has a reproduction characteristic that represents the reliability of this experimental result. The original material’s Shore hardness was reduced by 44.95%, from 85 A to 46.79 A, which represents an effective improvement in wearability.

Partnering With Families of Medically Complex Children Transitioning From the Hospital to Home.

Partnering With Families of Medically Complex Children Transitioning From the Hospital to Home.

Caracterização clínica de idosos com estomia atendidos em consulta de enfermagem em um centro de referência

Objetivo: caracterizar o perfil clínico de idosos com estomia atendidos em consultas de enfermagem em um centro de referência.Método: estudo descritivo de abordagem quantitativa com amostra intencional composta por 171 idosos. A pesquisa foi realizada em um centro de referência para estomias durante o atendimento de consultas de enfermagem. Os dados foram coletados no período de abril de 2018 a abril de 2019, e analisados conforme estatística descritiva simples.Resultados: do total de pacientes idosos atendidos no período analisado, observou-se que a média de idade entre eles foi de 71,6 anos, e não houve diferença significativa em relação ao sexo. A estomia mais frequentemente apresentada foi a colostomia (63,15%) e a neoplasia predominante nos pacientes foi a neoplasia maligna do reto (31,58%). Apenas 6 (3,51%) dos idosos apresentam estomia em virtude da doençadiverticular do intestino grosso com perfuração e abscesso. O principal motivo para consulta foi para realizar a troca da bolsa com 570 (62,10%), seguido por solicitação de avaliação 102 (11,11%). O quantitativo de consultas por gênero, revelam que as idosas buscam menos atendimento de enfermagem quando comparados aos homens.Conclusão: o conhecimento referente à caracterização dos idosos com estomia possibilitará a adequação do planejamento da assistência aos idosos estomizados dispondo de melhor qualidade e efetividade pela enfermeira estomaterapeuta no centro de referência.

Biocompatible hydrogel ostomy adhesive

AbstractOstomies are digestive and excretory surgeries where waste is redirected to the outside of the abdomen, requiring a bag to catch excretion. Current methods use adhesives to create adhesion for 24‐h usage of the ostomy bag. However, current adhesives are weak and unstable, and often lead to leakages of ostomy effluents resulting in various clinical complications including irritant dermatitis and infection. Due to these challenges, no commercially available product provides strong enough adhesion nor mechanical softness to prevent skin damage from ostomy leaks. In this work, we introduce a hydrogel ostomy adhesive (HOA) made from a tough double‐network hydrogel based on polyacrylamide and sodium alginate that strongly adheres onto the skin for over 24 h and prevents leaks by maintaining fluid‐tight sealing against regular bodily movements. The adhesion of HOA to abdominal skin is achieved by the topological adhesion formed by a biopolymer chitosan solution. The HOA’s robust adhesion of an ostomy bag is demonstrated on ex vivo porcine skin and in vivo human skin and is compared with existing commercially available ostomy bag adhesives.

Restricted v. unrestricted oral intake in high output end-jejunostomy patients referred to reconstructive surgery.

The major complication of end jejunostomy is excessive fluid and electrolyte loss through the stoma, leading to hypovolaemia and dyselectrolytaemia within days and malnutrition within weeks. The aim was to compare the results of two nutritional approaches: unrestricted and restricted oral intake in patients with end jejunostomy commencing home parenteral nutrition (HPN) in terms of liver and renal biochemical markers and time to reconstructive bowel surgery with correlation to stoma output. Twenty patients with stabilised high output end-jejunostomy were divided into two groups. Group A consisted of ten patients with oral intake restricted to keep stomal output under 1000 ml. Group B consisted of ten patients with unrestricted oral intake. The following parameters were evaluated over 6 months: stomal output, self-estimation of general condition, body weight gain, plasma bilirubin and creatinine, number of hospitalisations prior to reconstructive surgery, the frequency of ostomy bag emptying, feelings of hunger and thirst in the daytime, and the time to reconstructive surgery. Stoma losses were compensated by parenteral supply. In group B, lower quality of life was observed, reflected by weakness, permanent feelings of hunger and thirst and the need for night-time emptying of the stoma bag. Patients in group B developed more complications and required more time to prepare for surgery. One death occurred in group B due to renal insufficiency followed by septic complications. Restricted oral intake seems to be more effective for prevention of HPN-related complications and shortening of time to surgery. Unrestricted oral intake appears to provoke uncontrolled losses of energy and protein, inhibiting weight gain.

Effects of multifunctional butterfly-shaped chassis ostomy bag in incontinence-associated dermatitis

Objective To explore the effects of multifunctional butterfly-shaped chassis ostomy bag for faeces drainage in incontinence-associated dermatitis (IAD) . Methods From January to September 2019, this study selected 84 fecal incontinence patients with IAD of Intensive Care Unit in Zhejiang Provincial People's Hospital by convenient sampling. All of patients were divided into observation group (n=42) and control group (n=42) with the method of random number table. Control group carried out the IAD skin management trilogy combined with the common ostomy bag, while observation group implemented the IAD skin management trilogy combined with the multifunctional butterfly-shaped chassis ostomy bag. We compared the overall effective rate of treatment for IAD, nursing time of nurses for IAD, average retention time, average use time and replacement frequency of ostomy bag, family members satisfaction of patients between two groups. Results The overall effective rate of treatment for IAD in observation group was 95.24% (40/42) higher than that 73.81% (31/42) in control group with a statistical difference (P<0.05) . The nursing time and retention time of observation group was (1.89±0.32) h/d and (5.2±0.4) days per person respectively shorter than those [ (5.73±1.64) h/d and (9.4±1.2) days per person] of control group with statistical differences (P<0.05) . The use time of observation group was (98.27±12.18) hours per bag longer than that (72.18±4.63) hours per bag of control group with a statistical difference (P<0.05) . The replacement frequency of observation group was (1.20±0.10) times per person also statistically less than that [ (3.10±0.70) times per person] of control group (P<0.05) . Family members satisfaction of observation group was significantly higher than that of control group (P<0.05) . Conclusions Compared with traditional ostomy bag, the multifunctional butterfly-shaped chassis ostomy bag has effective treatments for IAD can shorten the nursing time for IAD, lengthen the use time of ostomy bag, reduce the average retention time and replacement frequency and improve family members satisfaction which can be widely used in clinical application. Key words: Butterfly-shaped; Ostomy bag; Incontinence- associated dermatitis