From the Department of Surgery, Western University, London, Ont. (Zwiep); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Helewa, Robertson); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Moloo); Lions Gate Hospital, Vancouver Coastal Health, Vancouver, BC (Hill); the Montfort Hospital, Ottawa, Ont. (Chaplain); and Nurses Specialized in Wound, Ostomy and Continence Canada, Ottawa, Ont. (Harley)
From the Department of Surgery, Western University, London, Ont. (Zwiep); the Department of Surgery, University of Manitoba, Winnipeg, Man. (Helewa, Robertson); the Department of Surgery, University of Ottawa, Ottawa, Ont. (Moloo); Lions Gate Hospital, Vancouver Coastal Health, Vancouver, BC (Hill); the Montfort Hospital, Ottawa, Ont. (Chaplain); and Nurses Specialized in Wound, Ostomy and Continence Canada, Ottawa, Ont. (Harley).
Can J Surg. 2022 May 25;65(3):E359-E363. doi: 10.1503/cjs.022320. Print 2022 May-Jun.
Every year, about 13 000 Canadians undergo an ostomy procedure, which requires stoma site marking to create a well-constructed stoma and prevent stoma-related complications. The Canadian Society of Colon and Rectal Surgeons (CSCRS) and Nurses Specialized in Wound, Ostomy and Continence Canada (NSWOCC) created a position statement to provide evidence-based guidance and techniques for stoma site selection.
A task force was formed comprising 20 health care professionals (7 colorectal surgeons from the CSCRS and 13 nurses from NSWOCC) with representation from across Canada. A literature review was performed, with the following databases searched from January 2009 to April 2019: MEDLINE, Embase, Cochrane, PubMed, CINAHL and Google Scholar. After the abstracts were screened, 6 task force members created a draft version of the position statement from the articles retained after full-text review. The draft was submitted to the entire task force for comments, and the ensuing modifications were incorporated. Peer reviewers were then recruited from the CSCRS and NSWOCC; a summary of their comments was reviewed by the task force, and modifications were incorporated to produce the final document.
The literature search identified 272 papers, of which 58 were reviewed after duplicates were excluded. After full-text review, 18 papers were included to guide the position statement. From these papers, we created a series of 17 steps for stoma site marking. Four general principles were found to be important for stoma site marking: obtain informed consent, identify important patient factors and landmarks, assess the abdomen and mark the most appropriate location. A 1-page enabler document and video were created as teaching aids and to help with dissemination of the information.
This position statement, associated enabler document and video provide evidence-based guidance for stoma site marking in both emergency and elective settings, and should be used by surgeons and nurses specialized in wound, ostomy and continence to identify optimal stoma sites preoperatively.
每年约有 13000 名加拿大人接受造口手术，这需要进行造口部位标记，以创建一个结构良好的造口并预防与造口相关的并发症。加拿大结肠直肠外科学会（CSCRS）和加拿大伤口、造口和失禁护士协会（NSWOCC）制定了一份立场声明，为造口部位选择提供循证指导和技术。
成立了一个由 20 名医疗保健专业人员（CSCRS 的 7 名结直肠外科医生和 NSWOCC 的 13 名护士）组成的工作组，代表来自加拿大各地。进行了文献回顾，从 2009 年 1 月至 2019 年 4 月，在以下数据库中进行了搜索：MEDLINE、Embase、Cochrane、PubMed、CINAHL 和 Google Scholar。在筛选摘要后，6 名工作组成员从全文审查后保留的文章中创建了立场声明的草案版本。该草案提交给整个工作组征求意见，并对随之而来的修改进行了合并。然后从 CSCRS 和 NSWOCC 招募了同行评审员；工作组审查了他们的评论摘要，并对修改内容进行了合并，以生成最终文件。
文献搜索确定了 272 篇论文，其中 58 篇在排除重复后进行了审查。经过全文审查，有 18 篇论文被纳入指导立场声明。从这些论文中，我们创建了一系列 17 个步骤进行造口部位标记。发现有四个一般原则对造口部位标记很重要：获得知情同意、识别重要的患者因素和标志物、评估腹部并标记最合适的位置。作为教学辅助工具和帮助传播信息，创建了一份一页的辅助文件和视频。
这份立场声明、相关的辅助文件和视频为急诊和择期环境中的造口部位标记提供了循证指导，外科医生和专门从事伤口、造口和失禁的护士应该在术前使用这些指导来确定最佳的造口部位。
