Risk factors for peristomal skin disorders associated with temporary ileostomy construction

Abstract

Purpose

Skin disorders are the most common stoma-related complications after temporary diverting loop ileostomy with proctectomy. The aim of the present study was to investigate risk factors for skin disorders associated with temporary ileostomy construction.

Methods

A total of 185 consecutive patients who underwent curative proctectomy with temporary diverting loop ileostomy for rectal malignancies at a single comprehensive cancer center between 2013 and 2018 were collected and analyzed.

Results

The most frequent stoma-related complications were skin disorders (n = 62, 33.5%), followed by mucocutaneous separation (n = 38, 20.5%) and high-output stoma (n = 34, 18.4%). Patients with skin disorders had a higher median body mass index (BMI; 22.4 vs. 21.3 kg/m2, P = 0.002) and lower stoma height (16 vs. 20 mm, P < 0.001) than those without skin disorders. According to a multivariable logistic regression analysis, independent predictors of skin disorders included overweight (median BMI ≥ 25 kg/m2 [odds ratio = 3.6, 95% confidence interval: 1.5–8.6], P = 0.004) and lower stomal height (median stoma height < 20 mm [odds ratio = 3.2, 95% confidence interval: 1.6–6.3], P < 0.001).

Conclusion

Overweight and lower stoma height are correlated with the presence of skin disorders. Construction of a well-elevated stoma can reduce skin disorders associated with temporary ileostomy construction.

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Acknowledgements

We sincerely thank the WOC nurses who provided patient care: Hitomi Kojima, Terumi Sasaki, and Mayumi Agata (Department of Nursing, the Aichi Cancer Center Hospital, Aichi, Japan). We also thank PROEDIT JAPAN for proofreading our draft.

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The authors received no specific funding for this work.

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Correspondence to Akira Ouchi.

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Maeda, S., Ouchi, A., Komori, K. et al. Risk factors for peristomal skin disorders associated with temporary ileostomy construction. Surg Today (2021). https://doi.org/10.1007/s00595-020-02209-x

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Keywords

  • Temporary ileostomy
  • Skin disorders
  • Height of stoma
  • Rectal surgery