Banu Tahmina, Talukder Rupom, Chowdhury Tanvir Kabir, Hoque Mozammel
Department of Pediatric Surgery, Chittagong Medical College and Hospital, Chittagong 4000, Bangladesh.
J Pediatr Surg. 2007 Jul;42(7):1263-5. doi: 10.1016/j.jpedsurg.2007.02.025.
BACKGROUND/PURPOSE: 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. We report the outcome of its use.
After construction of stoma, at first zinc oxide paste was applied on the peristomal skin. A betel leaf with shiny, smooth surface outwards and 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 and the fecal matter was washed away from both. The leaves were reused after cleaning. Leaves were changed every 2 to 3 days. From June 1998 to December 2005, in the department of pediatric surgery, Chittagong Medical College and Hospital, Chittagong, Bangladesh, a total of 623 patients had exteriorization of bowel. Of this total, 495 stomas were cared for with betel leaves and 128 with ostomy bags.
Of 623 children, 287 had sigmoid colostomy, 211 had transverse colostomy, 105 had ileostomy, and 20 had jejunostomy. Of the 495 children under betel leaf stoma care, 13 patients (2.6%) developed skin excoriation. There were no allergic reactions. Of the 128 patients using ostomy bag, 52 (40.65%) had skin excoriation. Twenty-four (18.75%) children developed some allergic reactions to adhesive. Monthly costs for betel leaves were 15 cents (10 BDT), whereas ostomy bags cost about US$24.
In the care of stoma, betel leaves are cheap, easy to handle, nonirritant, and nonallergic.
背景/目的：造口术是小儿外科手术中的常见操作。对于这些造口的护理，通常使用市售的造口袋等装置，有一次性的，也有使用时间较长的。这些装置价格昂贵，尤其是在孟加拉国这样的国家，而且合适尺寸的并不总是能买到。我们发现了一种适合孟加拉人的造口护理替代品——槟榔叶，并报告了其使用结果。
造口术后，首先在造口周围皮肤涂抹氧化锌糊剂。将一片表面光亮、光滑朝外、粗糙朝内的槟榔叶覆盖在造口上，根据造口大小在中间打一个孔。另一片完整的叶子覆盖造口开口。排便时，将上面的完整叶子取下，粪便从两片叶子上冲洗掉。叶子清洗后可重复使用。每2至3天更换叶子。1998年6月至2005年12月，在孟加拉国吉大港吉大港医学院医院小儿外科，共有623例患儿进行了肠造口术。其中，495个造口用槟榔叶护理，128个用造口袋护理。
623名儿童中，287例行乙状结肠造口术，211例行横结肠造口术，105例行回肠造口术，20例行空肠造口术。在495名接受槟榔叶造口护理的儿童中，13例（2.6%）出现皮肤擦伤。无过敏反应。在128名使用造口袋的患者中，52例（40.65%）出现皮肤擦伤。24例（18.75%）儿童对粘合剂出现一些过敏反应。槟榔叶每月费用为15美分（10孟加拉塔卡），而造口袋费用约为24美元。
在造口护理中，槟榔叶价格便宜、易于操作、无刺激性且无过敏反应。
