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使用可塑形皮肤屏障对造口人士造口周围皮肤状况的影响:一项前瞻性、观察性、多国研究的结果

The effects of using a moldable skin barrier on peristomal skin condition in persons with an ostomy: results of a prospective, observational, multinational study.

作者信息

Szewczyk Maria Teresa, Majewska Grazyna, Cabral Mary V, Hölzel-Piontek Karin

机构信息

Nicolaus Copernicus University; and Ludwik Rydygier Collegium Medicum, Department of Surgery, Clinic of Vascular Surgery and Specialistic Center for the Treatment of Chronic Wounds, University Teaching Hospital of Dr. Jurasz, Bydgoszcz, Poland.

Ostomy Outpatient Clinic, Medical University Teaching Hospital, Bialystok, Poland.

出版信息

Ostomy Wound Manage. 2014 Dec;60(12):16-26.

Abstract

Peristomal skin problems are the most commonly experienced physical complication following ostomy surgery and often are caused by leakage or a poorly fitting skin barrier. A prospective, multicenter, observational evaluation of persons with a colostomy, ileostomy, or urostomy was conducted to assess the incidence of peristomal lesions and level of patient satisfaction with moldable skin barriers. Peristomal skin was assessed using the Studio Alterazoni Cutanee Stomale (SACS™) scale, and patients were asked to rate barrier application and usage variables. During a period of 12 months, and using convenience sampling, 561 patients from 90 centers in 3 countries were enrolled: 28 in Germany, 48 in Poland, and 14 in the United States. Participants included 277 new stoma patients (average time since surgery 0.3 months; average age 64.7 ± 12.86 years) who had a colostomy (174), ileostomy (72), or urostomy (10); and 284 patients with an existing stoma (average time since surgery 18.2 months; average age 66 ± 12.62 years) who had a colostomy (174), ileostomy (88), or urostomy (22) who experienced skin complications using a traditional skin barrier (ie, a solid or flexible barrier with precut opening or one requiring cutting an opening to accommodate the stoma). All patients were assessed at baseline and after 1 and 2 months. In the patients with a new stoma, 225 (90.4%) had intact skin at baseline, 239 (95.6%) had intact skin after 2 months, and 98% rated overall satisfaction with the barrier as good or excellent. In the patients with an existing stoma, intact skin was observed in 103 patients (39.5%) at baseline and 225 (86.2%) after 2 months, with 96.5% of patients rating overall satisfaction with the barrier as good or excellent. In this group, the proportion of patients who used accessory products (eg, belt, deodorants, powder) was 73% at baseline and 64.2% at the 2-month follow-up. The moldable skin barriers evaluated were effective in preventing and healing peristomal skin complications and were rated as good or excellent by the vast majority of patients. Comparative studies are warranted to evaluate the efficacy and cost-effectiveness of this moldable skin barrier.

摘要

造口周围皮肤问题是造口手术后最常见的身体并发症,通常由渗漏或皮肤屏障贴合不佳引起。对结肠造口术、回肠造口术或尿路造口术患者进行了一项前瞻性、多中心观察性评估,以评估造口周围病变的发生率以及患者对可塑形皮肤屏障的满意度。使用造口周围皮肤工作室(SACS™)量表评估造口周围皮肤,并要求患者对屏障的应用和使用变量进行评分。在12个月期间,采用方便抽样法,纳入了来自3个国家90个中心的561例患者:德国28例,波兰48例,美国14例。参与者包括277例新造口患者(术后平均时间0.3个月;平均年龄64.7±12.86岁),其中有结肠造口术(174例)、回肠造口术(72例)或尿路造口术(10例);以及284例已有造口的患者(术后平均时间18.2个月;平均年龄66±12.62岁),其中有结肠造口术(174例)、回肠造口术(88例)或尿路造口术(22例),这些患者使用传统皮肤屏障(即带有预切口开口的固体或柔性屏障或需要切割开口以容纳造口的屏障)时出现了皮肤并发症。所有患者在基线时以及1个月和2个月后进行评估。在新造口患者中,225例(90.4%)在基线时皮肤完好,239例(95.6%)在2个月后皮肤完好,98%的患者对屏障的总体满意度为良好或优秀。在已有造口的患者中,103例(39.5%)在基线时皮肤完好,225例(86.2%)在2个月后皮肤完好,96.5%的患者对屏障的总体满意度为良好或优秀。在该组中,使用辅助产品(如腰带、除臭剂、粉末)的患者比例在基线时为73%,在2个月随访时为64.2%。所评估的可塑形皮肤屏障在预防和治愈造口周围皮肤并发症方面有效,并且被绝大多数患者评为良好或优秀。有必要进行比较研究以评估这种可塑形皮肤屏障的疗效和成本效益。

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