Journal
JOURNAL OF WOUND OSTOMY AND CONTINENCE NURSING
Volume 48, Issue 1, Pages 39-43Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/WON.0000000000000730
Keywords
Defunctioning stoma; Loop ileostomy; Loop stoma; Stoma bridge; Stoma retraction; Stoma rod
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The study evaluated the use of a rod (bridge) to prevent stoma retraction during ostomy construction, finding that while it did not reduce the risk of stoma retraction, it may lead to other adverse events. Therefore, the authors recommend avoiding stoma rod/bridge placement during ostomy surgery.
PURPOSE We evaluated evidence related to the use of a rod (bridge) to prevent stoma retraction during loop ostomy construction. METHODS: We completed a systematic review of the literature. We searched MEDLINE, EMBASE, and COCHRANE databases up to December 4, 2019. We posed the following question based on a PICO format. Do adult patients undergoing ostomy surgery experience less stomal retraction when compared to patients managed without placement of a stoma rod? FINDINGS: Our initial search returned 182 articles; after reading studies in full, 5 articles were identified that collectively enrolled 1058 participants. Four studies were randomized controlled trials and one was a prospective cohort study. Meta-analysis could not be performed because of the small number of studies and the heterogeneity of outcomes measurements. The incidence of stoma retraction ranged between 0%-8% in patients managed with a rod and 0.78%-8.2% in patients with no rod. The number of reported adverse events was low. Placement of a stoma rod was associated with more adverse outcomes than in patients managed without a rod. Adverse events included local edema, stoma necrosis, skin necrosis, peristomal moisture-associated skin damage (irritant dermatitis), peristomal abscess, bleeding, and mucocutaneous separation. CONCLUSIONS: Stoma rod does not seem to reduce the risk of stoma retraction and might result in other adverse events. IMPLICATIONS: We recommend avoidance of stoma rod/bridge placement during ostomy surgery.
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