Rod in loop ileostomy: Just an insignificant detail for ileostomy-related complications?

Marco Scarpa, Laura Sadocchi, Cesare Ruffolo, Maurizio Iacobone, Teresa Filosa, Daniela Prando, Lino Polese, Mauro Frego, Davide F. D'Amico, Imerio Angriman

Research output: Contribution to journalArticlepeer-review

Abstract

Background and aims: The aim of this prospective study was to validate a variant in the loop ileostomy construction to reduce peristomal pressure ulcers and, subsequently, the need of stoma therapist assistance and the frequency of changing the stoma appliance. Patients and methods: We have enrolled 33 consecutive patients who underwent two stage restorative proctocolectomies. The first consecutive 13 patients operated on had their ileostomies constructed with a standard rod. In the following 20 patients, we placed a 5.3-mm suction catheter tube closed with a stitch to form a "ring" and without any stitches fixing it to the skin. Results: In the "ring" rod group 40% of patients did not report any complication compared to the 8% of patients in the standard rod group (p = 0.046). Pressure ulcers were absent in this group, while it affected 61% of the patients in the standard rod group (p <0.001). Patients in the "ring" rod group needed significantly less assistance time by the stoma therapist (p <0.01) and required significantly fewer stoma appliance changes (p <0.01). In our institution, the overall cost for the complete management of a standard rod ileostomy was 73.16 (29.83-130.49) euro compared to 46.65 (23.15-93.48) euro for a "ring" rod ileostomy (p = 0.002). Conclusions: The adoption of a "ring" rod configuration led to an elimination of pressure ulcers due to the rigid rod, a shorter time requirement for stoma care and a decreased number of appliances required and was subsequently associated with lower costs of assistance. A tighter fitting around the ileostomy that avoided stool infiltration improved the practical management of the stoma with a "ring" rod.

Original languageEnglish
Pages (from-to)149-154
Number of pages6
JournalLangenbeck's Archives of Surgery
Volume392
Issue number2
DOIs
Publication statusPublished - Mar 2007

Keywords

  • Loop ileostomy
  • Restorative proctocolectomy

ASJC Scopus subject areas

  • Surgery

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