Factors Affecting Ostomy-Related Complications in Korea

PURPOSE: We sought to determine the type and incidence of ostomy-related complications and identify associated factors in Korean ostomy patients. METHODS: A retrospective analysis of medical records of 1,170 patients who underwent end colostomy in Samsung Medical Center between October 1994 and February 2005 was completed. Complications were classified as stomal or peristomal. Stomal complications included bleeding, necrosis, mucocutaneous separation, prolapsed stoma, retracted stoma, and stenosis. Peristomal complications included varices, hernia, irritant contact dermatitis, allergic contact dermatitis, maceration, folliculitis, hyperplastic granulation, bacterial infection, candidal infection, malignancy in the peristomal area, mechanical damage, and pyoderma gangrenosum. A flat (flush) stoma was the most common stomal complication, occurring in 8.5% of subjects. Irritant contact dermatitis, occurring in 15.5%, was the most common peristomal complication. Gender and body mass index were associated with irritant contact dermatitis, hyperplasia, peristomal hernias, flat stomas, and retracted stomas. CONCLUSIONS: Education for preventing irritant contact dermatitis, such as proper pouching and peristomal skin protection, and for weight control, should be emphasized in a selfcare program for persons living with an ostomy. Preoperative marking by a WOC nurse is needed to reduce the prevalence of flat (flush) stomas.