Qiao Yi, Xi Beihua, Zhang Yin
In the Department of Nursing, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China, Yi Qiao, MMed, RN, is Enterostomal Therapist; Beihua Xi, BMed, RN, is Enterostomal Therapist; and Yin Zhang, BMed, RN is Chief Nurse. Submitted April 28, 2024; accepted in revised form October 16, 2024.
Adv Skin Wound Care. 2025 Jun 1;38(5):254-257. doi: 10.1097/ASW.0000000000000289. Epub 2025 Apr 15.
To report on the current state of outpatient nursing care for patients with an intestinal fistula in a stoma clinic in China.
This retrospective study included 41 patients with an intestinal fistula who visited the stoma clinic in a tertiary hospital in Shanghai, China, between January 2019 and December 2023. Electronic medical records were selected for analysis of patients' clinical data, fistula diagnosis and treatment process, and outcome regression.
Few patients with an intestinal fistula are referred to the stoma clinic for nursing care (1.29%). At patients' first visit to the stoma clinic, the majority of those with an intestinal fistula (87.80%) had perifistular moisture-associated skin damage (MASD). The mean discolor, erosion, and tissue score was 6.73 ± 4.35, the mean healing time for MASD was 8.77 ± 8.51 days, and the mean number of follow-ups was 3.41 ± 1.92. The majority of patients (87.80%) complained of accompanying pain of different degrees. The mean self-healing time for nonoperative treatment was 301.96 ± 193.95 days. Enterostomal therapists applied the dressings to care for the skin around the fistula and formulated and guided a personalized management method to effectively contain output.
The quality of outpatient nursing care for patients with an intestinal fistula needs to be optimized. Standardized assessment and individualized precise intervention can reduce the incidence of complications such as MASD and improve the quality of care and prognosis of patients.
报告中国一家造口门诊对肠瘘患者门诊护理的现状。
这项回顾性研究纳入了2019年1月至2023年12月期间在中国上海一家三级医院造口门诊就诊的41例肠瘘患者。选取电子病历分析患者的临床资料、肠瘘诊断及治疗过程以及结局回归情况。
很少有肠瘘患者被转诊至造口门诊接受护理(1.29%)。在患者首次就诊于造口门诊时,大多数肠瘘患者(87.80%)存在瘘口周围湿性相关皮肤损伤(MASD)。变色、糜烂和组织评分的平均值为6.73±4.35,MASD的平均愈合时间为8.77±8.51天,平均随访次数为3.41±1.92次。大多数患者(87.80%)主诉伴有不同程度的疼痛。非手术治疗的平均自愈时间为301.96±193.95天。造口治疗师应用敷料护理瘘口周围皮肤,并制定和指导个性化管理方法以有效控制肠液输出。
肠瘘患者门诊护理质量有待优化。标准化评估和个体化精准干预可降低MASD等并发症的发生率,提高患者的护理质量和预后。