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Elective stoma construction improves outcomes in medically intractable pressure ulcers.

Publication ,  Journal Article
de la Fuente, SG; Levin, LS; Reynolds, JD; Olivares, C; Pappas, TN; Ludwig, KA; Mantyh, CR
Published in: Dis Colon Rectum
November 2003

PURPOSE: Perineal pressure ulcers are a common and devastating complication for paralyzed or chronically bedridden patients. Controversy exists on the benefit of fecal diversion for the treatment and prevention of these ulcers. This study compared outcomes in bed-bound patients with pressure ulcers who electively underwent fecal diversion with those who did not. METHODS: A retrospective review was performed on all disabled patients who underwent surgery for medically intractable pressure ulcer from 1993 to 2001. Charts were divided into the colostomy group or noncolostomy group. Recurrence rates, healing times, morbidity and mortality, and number of reoperations were calculated for each group. Additionally, stoma patients were interviewed for quality of life assessment. RESULTS: Sixty-seven patients were treated during the study period (colostomy, n = 41; noncolostomy, n = 26). The majority of colostomies were performed laparoscopically, with a 9.7 percent incidence of postoperative complications. The ulcer recurrence rate was lower in the treated colostomy group (43 percent) compared with the noncolostomy group (69 percent; P < 0.05). In addition, noncolostomy patients had longer healing times (7 vs. 3 months; P < 0.05), and this group required more ulcer operations than the stoma patients did. Quality of life and bowel care were much improved by the colostomy. CONCLUSIONS: Stoma construction is a safe procedure with low morbidity and mortality that helps heal pressure ulcers and decreases the incidence of recurrence. Additionally, laparoscopic stoma construction represents a technical advance that may reduce operative complications that have been previously reported with open fecal diversion.

Duke Scholars

Published In

Dis Colon Rectum

DOI

ISSN

0012-3706

Publication Date

November 2003

Volume

46

Issue

11

Start / End Page

1525 / 1530

Location

United States

Related Subject Headings

  • Wound Healing
  • Treatment Outcome
  • Surgery
  • Secondary Prevention
  • Retrospective Studies
  • Pressure Ulcer
  • Postoperative Complications
  • Middle Aged
  • Male
  • Laparoscopy
 

Citation

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de la Fuente, S. G., Levin, L. S., Reynolds, J. D., Olivares, C., Pappas, T. N., Ludwig, K. A., & Mantyh, C. R. (2003). Elective stoma construction improves outcomes in medically intractable pressure ulcers. Dis Colon Rectum, 46(11), 1525–1530. https://doi.org/10.1007/s10350-004-6808-6
Fuente, Sebastian G. de la, L Scott Levin, James D. Reynolds, Carmen Olivares, Theodore N. Pappas, Kirk A. Ludwig, and Christopher R. Mantyh. “Elective stoma construction improves outcomes in medically intractable pressure ulcers.Dis Colon Rectum 46, no. 11 (November 2003): 1525–30. https://doi.org/10.1007/s10350-004-6808-6.
de la Fuente SG, Levin LS, Reynolds JD, Olivares C, Pappas TN, Ludwig KA, et al. Elective stoma construction improves outcomes in medically intractable pressure ulcers. Dis Colon Rectum. 2003 Nov;46(11):1525–30.
de la Fuente, Sebastian G., et al. “Elective stoma construction improves outcomes in medically intractable pressure ulcers.Dis Colon Rectum, vol. 46, no. 11, Nov. 2003, pp. 1525–30. Pubmed, doi:10.1007/s10350-004-6808-6.
de la Fuente SG, Levin LS, Reynolds JD, Olivares C, Pappas TN, Ludwig KA, Mantyh CR. Elective stoma construction improves outcomes in medically intractable pressure ulcers. Dis Colon Rectum. 2003 Nov;46(11):1525–1530.
Journal cover image

Published In

Dis Colon Rectum

DOI

ISSN

0012-3706

Publication Date

November 2003

Volume

46

Issue

11

Start / End Page

1525 / 1530

Location

United States

Related Subject Headings

  • Wound Healing
  • Treatment Outcome
  • Surgery
  • Secondary Prevention
  • Retrospective Studies
  • Pressure Ulcer
  • Postoperative Complications
  • Middle Aged
  • Male
  • Laparoscopy