LeBlanc Kimberly, Whiteley Ian, McNichol Laurie, Salvadalena Ginger, Gray Mikel
Kimberly LeBlanc, PhD, RN, NSWOC, WOCC(C), Wound Ostomy Continence Institute, Association for Nurses Specialized in Wound Ostomy Continence Canada (NSWOCC), Ottawa, Ontario, Canada. Ian Whiteley, MNurs, NP, STN, Concord Repatriation General Hospital, Sydney, New South Wales, Australia. Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN, Cone Health, Greensboro, North Carolina. Ginger Salvadalena, PhD, RN, Clinical Affairs, Hollister Incorporated, Libertyville, Illinois. Mikel Gray, PhD, RN, FNP, PNP, CUNP, CCCN, FAANP, FAAN, School of Medicine (Department of Urology) and School of Nursing (Department of Acute and Specialty Practice), University of Virginia, Charlottesville, Illinois.
J Wound Ostomy Continence Nurs. 2019 Mar/Apr;46(2):125-136. doi: 10.1097/WON.0000000000000513.
Stomal and peristomal skin complications (PSCs) are prevalent in persons living with an ostomy; more than 80% of individuals with an ostomy will experience a stomal or peristomal complication within 2 years of ostomy surgery. Peristomal skin problems are especially prevalent, and a growing body of evidence indicates that they are associated with clinically relevant impairments in physical function, multiple components of health-related quality of life, and higher costs. Several mechanisms are strongly linked to PSCs including medical adhesive-related skin injuries (MARSIs). Peristomal MARSIs are defined as erythema, epidermal stripping or skin tears, erosion, bulla, or vesicle observed after removal of an adhesive ostomy pouching system. A working group of 3 clinicians with knowledge of peristomal skin health completed a scoping review that revealed a significant paucity of evidence regarding the epidemiology and management of peristomal MARSIs. As a result, an international panel of experts in ostomy care and peristomal MARSIs was convened that used a formal process to generate consensus-based statements providing guidance concerning the assessment, prevention, and treatment of peristomal MARSIs. This article summarizes the results of the scoping review and the 21 consensus-based statements used to guide assessment, prevention, and treatment of peristomal MARSIs, along with recommendations for research priorities.
造口及造口周围皮肤并发症（PSCs）在造口患者中很常见；超过80%的造口患者在造口手术后2年内会出现造口或造口周围并发症。造口周围皮肤问题尤为普遍，越来越多的证据表明，它们与身体功能的临床相关损害、健康相关生活质量的多个组成部分以及更高的成本有关。有几种机制与PSCs密切相关，包括与医用胶粘剂相关的皮肤损伤（MARSIs）。造口周围MARSIs定义为在移除粘性造口袋系统后观察到的红斑、表皮剥脱或皮肤撕裂、糜烂、水疱或大疱。一个由3名了解造口周围皮肤健康情况的临床医生组成的工作组完成了一项范围审查，结果显示关于造口周围MARSIs的流行病学和管理的证据严重不足。因此，召集了一个造口护理和造口周围MARSIs国际专家小组，该小组采用正式程序，形成基于共识的声明，为造口周围MARSIs的评估、预防和治疗提供指导。本文总结了范围审查的结果以及用于指导造口周围MARSIs评估、预防和治疗的21项基于共识的声明，以及对研究重点的建议。
