PubMed · 3693675
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M G Ritter. Role implementation: ET nursing.. https://pubmed.ncbi.nlm.nih.gov/3693675/
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We examined surgical treatment, outcome, and histological findings in very low birth weight (VLBW) infants with functional isolated small bowel obstruction (FISBO) and idiopathic gastrointestinal perforation (IGIP). The files of 18 neonates (average gestational age 27.5 weeks; average birth weight 880 g), surgically treated for IGIP ( n = 12) or FISBO ( n = 6), were retrospectively reviewed. In both groups segmental or diffuse dilatation of the small bowel was seen. All but two perforations were localized in the small bowel. In half of the patients a discontinuous absence of the internal layer of the muscularis propria or muscularis mucosae was found. Signs of necrotizing enterocolitis (NEC) were absent. Most of the patients were treated with an enterostomy (IGIP: n = 11; FISBO: n = 4). Overall survival in both groups was 83%. Follow-up after enterostomy closure (mean 23 months) shows normal gastrointestinal function without failure to thrive in 67% of the survivors. Muscular wall abnormalities and small bowel distension are found in both FISBO and IGIP. Although the underlying etiology remains unclear, segmental muscular wall absence may be a major predisposing factor in both conditions. Creation of a temporary enterostomy is a valid surgical option in VLBW infants with minimal risk for recurrent obstruction and/or perforation. Survival and long-term gastrointestinal function is excellent. IGIP should be distinguished from NEC.
This article provides a review of diseases affecting preterm neonates that may result in fecal diversion and types of stomas created during surgical intervention. Characteristics influencing ostomy management in this population, particularly skin barrier properties, are examined. Finally, ostomy equipment and pouching techniques are discussed to provide health professionals with clinically-based guidelines and practical strategies for managing premature ostomates.
A stoma nurse provides information, counselling and care to patients with gastrointestinal and urological conditions such as a stoma, incontinence, fistulas or an ileoanal anastomosis with a pouch. The stoma nurse will provide the patient and his or her partner with pre-operative information, post-operative counselling, practical care and instruction as well as check-ups at the outpatients' clinic. Careful selection of the most suitable collection device is highly important. This stoma care has a positive effect on the quality of life of a patient with a stoma. The most common complication is peristomal dermatitis which, in combination with care problems, may lead to social restrictions. Providing the patient's physical and psychological health is not in danger, the stoma care nurse can treat or control these complications, thereby avoiding the need for further surgery.