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Outcomes following stoma formation in patients with spinal cord injury
Author(s) -
Cooper E. A.,
Bonne Lee B.,
Muhlmann M.
Publication year - 2019
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.14753
Subject(s) - medicine , stoma (medicine) , constipation , spinal cord injury , quality of life (healthcare) , bowel management , fecal incontinence , physical therapy , ileostomy , surgery , general surgery , spinal cord , nursing , psychiatry
Aim The formation of a diverting stoma of the bowel in patients with spinal cord injury ( SCI ) is a useful option in managing problems associated with prolonged bowel care, pressure ulcers and neurogenic bowel. This descriptive study examines surgical outcomes and the effect on an individual's health‐related quality of life (HrQoL) in this complex group of patients. Methods Data were retrospectively collected in all patients with SCI who underwent a diverting stoma at Prince of Wales Hospital, Sydney, between January 2013 and January 2018 via a self‐report questionnaire developed specifically for the study. Results Forty‐three individuals were identified of whom 26 responded. 73% were men with a mean age of 45 years. The reasons for stoma formation included sacral pressure ulcer (50%), prolonged bowel care (35%), faecal incontinence (19%), constipation (8%), autonomic dysreflexia (8%), carer difficulties (8%) and haemorrhoids (4%). 76% of patients reported an improvement in HrQoL with 72% scoring their satisfaction with a stoma ≥ 8/10. Conclusion While stoma formation is often seen as a treatment of last resort, our study has shown that it is an effective management option for a number of conditions post‐ SCI . It can improve HrQoL and has a high level of satisfaction amongst patients. Ideally, patients who could potentially benefit from a stoma should be identified early and receive appropriate education and counselling to help facilitate informed and timely decision‐making and reduce adverse bowel related impact on quality of life and adjustment post‐ SCI .