Background: Peristomal skin lesions are frequent complications of ostomy; however, there is no generally accepted nomenclature and classification system.
Objective: An interdisciplinary German expert panel (GESS) composed of ten members, developed an innovative semiquantitative classification system for peristomal skin lesions for further stratification of ostomy therapy. This score is based on criteria which can be assessed by stomal therapists and treating physicians.
Results: The new peristomal skin lesion score grades three categories: lesion (L), status of ostomy (S) and disease (D). The L category describes the integrity of the skin as normal (L0), lesion with sustained integrity of skin (L1), integrity destroyed (L2) and local infection (L3). The S category rates the complexity of ostomy therapy as normal (S0), increased (S1) and high but not sufficiently effective (S2). The additional letters for categorization O. R. P. H. E. US describe anatomical pathologies of the stoma itself: ostomy stenosis (O), retraction (R), prolapse (P), hernia (H), edema (E) and unfavorable site (US). A systemic disorder is either absent (D0), irrelevant (D1) or relevant (D2). The LSD score is the basis for a management algorithm.
Conclusion: The LSD score is comprehensive, standardized and holistic. Its straightforward use by health professionals can improve the consistency of the description of skin lesions and enhance the quality of ostomy therapy.
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http://dx.doi.org/10.1007/s00104-015-0044-6 | DOI Listing |
Skinmed
January 2025
Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA.
Pyoderma gangrenosum (PG) is the second most common skin manifestation reported in patients with inflammatory bowel disease (IBD). We performed a single-institution, retrospective study to summarize the clinical features and examine effective treatment regimens and outcomes of PG in IBD patients. We identified 45 patients who presented to our institute between January 1, 2002 and December 31, 2021 with the following criteria: (1) diagnosed with an active PG (ICD9: 686.
View Article and Find Full Text PDFCureus
December 2024
Department of Surgery, Kishiwada Tokushukai Hospital, Kishiwada, JPN.
A 61-year-old woman underwent an emergent operation with sigmoid colon cancer resection, colostomy, and ileostomy on colon perforation. The low ileostoma, caused by intra-abdominal bad conditions, had irritated the surrounding skin after surgery, intermittently forcing the patient to fast for a certain period. Six months after the operation, under the judgment that re-ileostomy, essential for hospital discharge, seemed very difficult through another laparotomy, we attempted to make the ileostoma higher not with pulling the ileum from the abdomen but with lowering the surrounding skin using skin flap formation techniques.
View Article and Find Full Text PDFTech Coloproctol
December 2024
Unit of General Surgery, Santa Maria Della Misericordia Hospital, Rovigo, Italy.
Background: Diverting ileostomy is a common procedure in rectal cancer surgery, but it is sometimes associated with a nonnegligible rate of complications. The primary aim of this study was to analyze the incidence and types of stoma-related complications for ileostomy creation after rectal cancer resection. The secondary aims were to report the indications, the technical details, and the efficacy of stoma care provided by ostomy nurses.
View Article and Find Full Text PDFBr J Nurs
December 2024
Principal Scientific Manager, Coloplast A/S, Humlebæk, Denmark.
People with an outward peristomal body profile can experience difficulties obtaining a secure seal with a flat baseplate to the peristomal skin. Baseplates with a concave contour have been designed to provide a better fit to curved body profiles and reduce the risk of leakage. In this 4-week product evaluation, 110 individuals with an outward peristomal body profile using flat one-piece pouching systems were enrolled to evaluate the impact of a concave one-piece pouching system on wear time, unplanned changes of pouching systems and use of accessories.
View Article and Find Full Text PDFPediatr Surg Int
November 2024
Department of Surgery, The University of Auckland, Auckland, New Zealand.
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