J Korean Acad Nurs.  2011 Dec;41(6):814-820. 10.4040/jkan.2011.41.6.814.

Comparison of Standardized Peristomal Skin Care and Crusting Technique in Prevention of Peristomal Skin Problems in Ostomy Patients

• Park S
• Lee YJ
• Oh DN
• Kim J

• KMID: 1120114
• DOI: http://doi.org/10.4040/jkan.2011.41.6.814

Abstract

PURPOSE
This study was performed to compare the effects of standardized peristomal skin care (SPSC) and crusting technique (CT) on the peristomal skin of ostomates. SPSC was developed by a consensus among the expert group based on a comprehensive review of the relevant literature and hospital protocols.
METHODS
A randomized controlled pilot trial with 2 parallel arms was used. A total of 81 ostomates, who were recruited from a tertiary hospital, completed the baseline, 1-month, 2-month, and 3-month follow-up (SPSC group, n=45; CT group, n=36). SPSC consisted of water cleansing and direct application of ostomy appliances. CT involved crusting hydrocolloid powder and patting with water sponge or protective barrier liquid film. The outcomes of the study were assessed by skin problems, such as discoloration, erosion and tissue overgrowth; the domains of the evaluation tool used in examining the peristomal skin. A generalized estimating equation model was used to examine the effects according to time and group.
RESULTS
In both SPSC and CT groups, the likelihood of occurrence of discoloration (OR, 1.99; 95% CI, 1.61-2.46), erosion (OR, 1.87; 95% CI, 1.55-2.25) and tissue enlargement (OR, 1.94; 95% CI, 1.36-2.77) increased with time. There was no significant difference in discoloration between the groups, whereas the probability of erosion (OR, 0.38; 95% CI, 0.16-0.89) and tissue overgrowth (OR, 0.09; 95% CI, 0.02-0.55) was lower in the SPSC group than in CT group.
CONCLUSION
SPSC was sufficient in preventing peristomal skin problems of ostomates compared to the CT.

Keyword

Ostomy; Evidence-based practice; Skin care

MeSH Terms

Adult
Aged
Aged, 80 and over
Colorectal Neoplasms/surgery
Female
Follow-Up Studies
Humans
Inflammatory Bowel Diseases/surgery
Male
Middle Aged
Odds Ratio
Ostomy/*nursing
Skin Care/instrumentation/*methods/standards
Wounds and Injuries/etiology/prevention & control

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