Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Ostomy”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 703 records · Page 39Linked to original sources
PubMed2006

Structured visualization of expert nursing--An educational program for stoma self-care.

To provide an adequate educational program for patients with a stoma, we have developed an algorithm which was divided into three parts according to the period, i.e., the preoperative period, postoperative period, and rehabilitation period. It was composed of action nodes, thinking nodes, choice branches, assessment item tables, reference tables, and candidate logic tables. Wound Ostomy Continence Nurses (WOCNs) used this algorithm. The results indicated that the algorithm did not omit any important points involved in stoma care, and that it could therefore be successfully applied to patients with a stoma.

Humans↗
PubMed1991

Comparative study between modified Freyer's prostatectomy, classical Freyer's prostatectomy and Millin's prostatectomy.

Classical Freyer's method was modified in which, prostatic fossa was packed after the enucleation of the gland for hemostatic purpose; and the pack and suprapubic drain were brought out laterally. The pack was removed after 48-72 hours postoperatively and catheter was introduced per urethrum for early closure of suprapubic ostomy. Fifty such cases of Modified Freyer's prostatectomy were compared with cases of classical Freyer's prostatectomy (n = 25) and Millin's prostatectomy (n = 25). The duration of surgery and requirements for perioperative blood transfusion were found to be less with our method.

Humans↗
PubMed1991

Mechanical sutures in perforation of the thoracic esophagus as a safe procedure in patients seen late.

Between 1976 and 1988, we treated 13 perforations of the thoracic esophagus, excluding ruptured carcinoma and intraoperative wounds, by mechanical sutures without exclusion. The delay between perforation and treatment ranged from eight to 168 hours, more than 24 hours in 11. The length of perforation was 0.5 to 15.0 centimeters. Suture was covered with a flap in ten instances; an antireflux procedure was associated with five instances. No digestive ostomies were performed. There was one death; a patient who was comatose upon arrival. The results of this small series suggest that myotomy exposing the mucosa and a flap are two essential elements of the technique; perforations of less than 6 centimeters, even when seen late, may be treated by primary surgical closure.

Adult↗
PubMedDate not supplied

Body image in the person with a stoma.

Body image is the mental picture one has of one's physical being that develops from birth and continues throughout life and is related to different factors affecting its formation and dynamics. A crisis such as the creation of a stoma leads to an alteration in body image and an awareness of the meaning of the change in appearance and function of an individual. The individual's behavior is examined in several domains: physical, mental, emotional, social, sexual, and economical. When one domain is disturbed the others will be influenced. A person's rehabilitation after ostomy surgery is a continuous process of adaptation and is directed toward returning to a normal way of life. Many factors affect this adaptation to an alteration in body image and are relevant to the patient and family. These factors include, but are not limited to, the disease process, treatment(s), and medical and nursing care in the hospital and community. Knowledge about actual and potential problems associated with an alteration in body image enables the nurse to assess the meaning of the alteration in body image for the individual patient and family, provide counseling before and after the surgery, and intervene so that the individual will be able to adapt to an alteration in body image and return to one's previous activities of daily living and lifestyle.

Aged↗
PubMed1991

Technology's children: report of a statewide census of children dependent on medical supports.

In April 1987, a census of children dependent on medical technology was carried out in Massachusetts to determine the one-month point prevalence. All medical and educational providers in the state who were likely to interact with such children were contacted and asked to complete a two-sided data form on youngsters (aged 3 months to 18 years) with tracheostomies, supplementary oxygen, respirators, suctioning, gastric feeding, central venous lines, ostomies, ureteral diversion, urethral catheterization and dialysis. Nearly 1250 children were found meeting these criteria. Capture-recapture analysis set the lower bound for technology dependence at 0.08% of the state's children. An analysis of the organ systems involved showed that 57% of the children had neurologic involvement--13% multisystem, 7% gastrointestinal-metabolic, 4% renal-genitourinary, and 3% musculoskeletal. Less than 1% of the children were reported as having immunologic or "other" disorders. Review of putative etiologies indicated that 45% of the children had congenital anomalies, 33% chronic medical diseases, 9% perinatal conditions, 7% hereditary-genetic disorders, 5% injuries, 2% infections, and 3% "other." The substantial prevalence of technology dependency among children creates challenges at the social, economic, and policy-making levels. It will be important to carry out systematic reporting and monitoring activities throughout time and across sites. This census is an example of one such statewide effort.

Adolescent↗
PubMed1990

The role of second-look procedure in improving survival time for patients with mesenteric venous thrombosis.

Since 1978, 21 patients (12 men and nine women) suffering from mesenteric venous thrombosis (MVT) were treated at the Hadassah University Medical Center. The cause of MVT was multifactorial, and in only six patients was the process defined as primary or idiopathic. A preoperative diagnosis of MVT was made in eight patients. Surgical management of the individual patient was based on the extent of the ischemic process, the viability of infarcted intestine and the general condition of the patient. Nineteen patients were operated upon. Exploratory laparotomy without any attempt of intestinal resection was performed upon two patients. Eleven patients underwent resection and primary anastomosis. Second-look procedures were done upon ten patients, and in six, intestinal resection was followed by creation of a double ostomy. The over-all survival rate was reported to be 60 per cent; it was 71 per cent among the patients who were operated upon. The role of second-look procedures in improving survival time is outlined.

Adult↗
PubMedDate not supplied

Colostomy irrigations: mechanism guidelines and considerations.

Colostomy irrigation is most often indicated for the control of bowel function in a select population of patients. Irrigation of an ostomy may also be necessary to prepare to bowel prior to surgery or diagnostic testing, to alleviate constipation or impaction or to relieve a food blockage at the fascial opening of an ileostomy. To achieve a successful outcome with irrigation procedures, the practitioner must carefully consider the anatomy and physiology of the intestine as well as appreciate the patient's history, physical capability and unique situation.

Colon↗
PubMed1990

Contact dermatitis in hospital patients.

Contact dermatitis in hospital patients resulting from diagnostic and therapeutic procedures presents various causes and clinical aspects. Antiseptics are the most frequent cause of contact dermatitis in patients undergoing surgery. Thimerosal may cause allergic sensitization mainly in patients previously exposed to contact with different sources of these mercurials, such as tinctures and preservatives in other products. Iodine-containing solutions and quaternary ammonium compounds rarely sensitize. They may cause irritation under certain circumstances, however. Adhesive tapes formulated on a rubber and colophony base are rarely found nowadays in medical adhesives; however, some tapes and skin closures have still been found to contain them. Acrylate-based adhesives sensitize less frequently. Cardiology patients may present contact dermatitis from several different sources. Electrode gels and pastes may cause allergic contact dermatitis mainly from preservatives. Modern electrocardiographic equipment does not require the use of these products, so many of these problems are now easy to avoid. Adhesive-coated pregelled foam disks for holding long-term chest contacts may cause irritant dermatitis. Transdermal drug delivery systems such as nitroglycerin disks may cause irritation attributable to the acrylic adhesives. Silicone-based adhesive disks are a good alternative in this case. Sensitization to nitroglycerin itself is rare. Dermatitis originated from implantation of pacemakers is attributable either to epoxy resin or to the metal used for the casing of the pacemaker. Changing to a different material solves the problem. In other instances, the etiology remains unclear. Dermatoses in patients with stomas constitute an important problem not only because of their frequency but also because of the multiplicity of pictures involved. Irritant dermatitis from intestinal efflux in ileostomy patients is the most frequent problem. Allergic dermatitis may originate from the ostomy device, cementing materials, or topical medicaments. Individuals receiving hemodialysis have been reported to develop widespread dermatitis, probably secondary to rubber or metal components leached out from the hemodialysis apparatus. Systemic exposure to these compounds, although not certainly proved, seems to be the explanation. Allergic dermatitis at the puncture site on arteriovenous shunts has been demonstrated to be produced by epoxy resin adhesives present in catheters. Identification of the allergen allows one to find a safe alternative for these patients who depend on this procedure to survive. Contact dermatitis in hospital patients requires a precise diagnosis. Extensive patch testing is sometimes needed for establishing the cause, which in turn provides a more accurate prognosis and a rational treatment.

Adhesives↗
PubMed1989

Surgical therapy in ulcerative colitis.

Ulcerative colitis is cured if the colon and rectum are removed. The total proctocolectomy provides the cure, but the ileostomy is not well accepted by patients. Thus, alternatives that provide continence but have an increased morbidity have been introduced. The continent ileostomy (Koch pouch) has a valve created in an ileal pouch which provides continence. Intubation with a catheter is necessary and a flat ostomy is present. A colectomy with ileoproctostomy can be used to salvage the sphincter. Unfortunately, the diseased rectum is spared with its potential for progressive symptoms and cancer. The newest technique is also the most morbid. This procedure requires total colectomy, stripping of the rectal mucosa, formation of an ileal pouch, anastomosis of the pouch to the anus, and placement of a diverting ileostomy to allow complete healing without passage of stool. The failure rate is five to ten per cent, but most young people opt to save the sphincter and preserve their body image.

Colectomy↗
PubMed1989

Management of Hirschsprung's disease in adolescents.

It is unusual for Hirschsprung's disease to go undiagnosed until late childhood. Adolescents presenting with Hirschsprung's disease offer unique challenges to the surgeon because of the massively dilated and hypertrophied colon that is invariably present. Five adolescents (four males and one female; ages, 11 1/2 to 16 1/4 years) with newly diagnosed Hirschsprung's disease were managed by slightly different methods between January 1981 and March 1987. Three patients had a "leveling" colostomy, followed by a Swenson procedure in two and a Duhamel procedure with a temporary diverting colostomy in one. One patient had a primary Duhamel procedure with a temporary diverting ileostomy. One patient had a primary Swenson procedure without diversion. Long-term results were uniformly excellent. Based on the experience with these patients the following principles of management emerge: 1) Avoid loop "leveling" colostomies because of their grotesque size and their tendency to retract or prolapse. 2) Rectal tube decompression can often adequately prepare a patient for a primary pull-through procedure. 3) When a diverting ostomy is required, it should be an ileostomy rather than a colostomy because its subsequent closure will not endanger the marginal artery, which if divided, could compromise the blood supply to the pulled-through colon. 4) The Swenson procedure, although difficult in adolescents, can be done with excellent long-term results. 5) Several applications of the stapling instrument are required in the Duhamel procedure to fully divide the septum between the aganglionic rectum anteriorly and the normal colon posteriorly.

Adolescent↗
PubMed1989

The true cost of protective loop colostomy.

Transverse loop colostomies are commonly used to "protect" low colorectal anastomoses after anterior resection for rectal carcinoma. However, anastomotic leaks occur despite proximal decompression. We studied 61 consecutive patients who underwent anterior resection to evaluate the cost of loop colostomy as reflected by morbidity, mortality, and length of post-operative hospital stay. Colostomy patients had significantly greater blood loss (736 vs. 500 ml, p = 0.004), more blood transfusions (1.55 units vs. 0.41 units, p less than 0.001), and longer operations (238 vs. 193 min, p = 0.005). They were also older (68 vs. 65, p = 0.13), had lesions closer to the anal verge (10.2 vs. 11.4 cm, p = 0.07), and had more infectious complications (13.6% vs. 2.6%, 0.05 less than p less than 0.1) than patients without colostomies. Colostomy was not related to sex or stage. There were no anastomotic leaks among those with colostomies and only one among those without colostomies; there were no associated mortalities. Patients with colostomies stayed an additional 10 days, on average, when readmitted for colostomy closure. The 22 patients who received loop colostomies had postoperative stays averaging one-third longer than patients without colostomies (16 vs. 12 days, p = 0.004). In both groups, the 8th postoperative day was the mean for resumption of a regular diet; all patients were eating a regular diet by the 12th postoperative day. The delay in discharging colostomy patients was due to the additional time necessary for patients to learn to change their appliance and irrigate their stoma. Proximal diverting colostomies may more than double the total dollar cost of anterior resection, although DRG reimbursement is the same with or without a colostomy. This additional cost could be reduced by initiating ostomy teaching in the preoperative period and by reducing the use of unnecessary colostomies.

Adenocarcinoma↗
PubMed1987

V-Y closure for abdominal wall stomal reduction.

An excessively large abdominal wall stoma may prevent the correct fitting of an ostomy appliance causing significant morbidity and embarrassment. Skin excision and V-Y closure is a simple procedure that will increase patient comfort and facilitate management of the stoma. Laparotomy and extensive manipulation of the intestine are avoided.

Abdominal Muscles↗
PubMed1986

Cimetidine and parenteral nutrition in the ICU patient.

Cimetidine is often prescribed for hospitalized patients requiring intravenous nutritional support (ie, total parenteral nutrition). When administered parenterally, the drug may prevent excessive fluid and electrolyte loss in patients with short-bowel syndrome, particularly after resection. It may also help prevent anastomotic ulcers in patients following partial gastrectomy. In patients with hypersecretory disease or high-volume ostomy drainage, cimetidine is clinically useful in moderating secretions, thus reducing fluid and electrolyte loss. Cimetidine can prevent, and perhaps treat, metabolic alkalosis associated with significant losses of nasogastric aspirate. Intravenous administration of the drug to patients requiring nasogastric suction often eliminates the need for addition of hydrochloric acid to their parenteral nutrition admixtures. Cimetidine has been found to be physically compatible and chemically stable in crystalline amino acid/dextrose solutions and in crystalline amino acid/dextrose/lipid admixtures. As cimetidine is widely used in patients receiving total parenteral nutrition, it has become acceptable practice to deliver the drug via parenteral nutrition admixtures. Admixing the drug may be of particular advantage for patients with limited vascular access or for those who are fluid restricted. Cimetidine when given by continuous infusion may be more effective and require less drug per day than if administered via intermittent injection. Moreover, administration of cimetidine by continuous infusion to hyperalimentation patients has been documented to save the institution more than $22,000 a year in materials and labor costs.

Cimetidine↗
PubMed1988

[Intestinal perforation in abdominal contusions in children. 16 cases].

16 cases of intestinal perforation following blunt abdominal trauma in children (14 boys and 2 girls from 3, 5 to 15 years old) are recorded in a 18 years period. We found 12 injuries of the small bowel, 2 of the colon and 2 of the duodenum. Except in the cases with hypovolemia or traumatic coma, the diagnosis is often made on abdominal physical findings and clinical evolution. Laboratory and radiological data were often useless. Then, surgical management was often delayed, principally in the most recent period with the non operative management of most pediatric blunt trauma. Simple closure (7 cases), resection and anastomosis (7 cases) or resection and double ostomy (2 cases) were performed. The result summarize 2 death and one complication (fistula). Complications do not increase with delay.

Abdominal Injuries↗
PubMedDate not supplied

Risk of infection following penetrating abdominal trauma: a selective review.

Post-operative infectious complications following penetrating abdominal trauma are a major cause of morbidity and contribute significantly to increased length of hospitalization and costs of patient care. Our recent study suggests the individual patient's probability of major infection following traumatic intestinal perforation is high and can be predicted from risk factors identified at the time of surgery. The determinant of primary importance for development of infection confirmed by this study is peritoneal contamination by intestinal contents. Other significant risk factors (p less than 0.05) were number of organs injured, number of units of blood administered, ostomy formation for left colon injury, and the patient's age. Risk of infection can be calculated from these data and could potentially be used to guide post-operative decisions. Areas of trauma care in which alteration of therapy might result in significant savings include choice of antibiotics, duration of antibiotic administration, and wound management. This study supports the use of standardized operative procedures and parenteral antibiotics effective against endogenous aerobic and anaerobic organisms. If such observations continue to be supported by further randomized prospective studies, there is tremendous potential to further tailor surgical management for the individual patient in a more cost-effective manner.

Abdominal Injuries↗
PubMed1987

Peristomal skin integrity.

The primary goal of skin care for the person with a stoma is prevention of skin breakdown. The first step is careful maintenance of the skin from the time of surgery forward. The patient and family should be taught every step of protecting the skin and recognizing early signs and symptoms of potential breakdown. The loss of peristomal skin integrity affects the person's entire well-being. Pouches will not adhere as well and accidental leaks occur. The impact on psychologic well-being is difficult to measure, but can be assumed to be significant. A circular effect can begin in which the skin irritation leads to accidents, which further compromise the skin integrity. Time may be lost from work or school. Damaged skin is also painful. The cost of treating peristomal skin breakdown can be high. The products used in ostomy care are relatively expensive. A single skin barrier may range from $3 to $5. Frequent changes will be necessary to assess and treat the lesions adding to the cost. Prevention is in the realm of effective nursing care and will include assessment of the skin, selection and application of appropriate pouches and skin barriers, patient and family teaching programs, and follow-up evaluations after hospitalization.

Colostomy↗
PubMed1985

Sexuality in cancer patients.

The sexual concerns of patients with cancer may be overlooked during the acute stage of illness. Both the general stress of hospitalization and the specific threat of surgery can affect sexuality. Breast cancer and cancer of the reproductive organs cause the most concern, although other tumors can be as devastating. "Ostomies" and limb amputations raise special questions, and radiation therapy affects sexual and reproductive function. Underlying depression has a profound effect.

Adult↗
PubMed1985

Proximal decompression by tube appendicostomy with pull through procedures in pediatric operations.

The technique of tube appendicostomy for proximal decompression of anastomosis at the anus and colon after pull-through operations in children is described. It has been used in 29 patients with good results without complications and allows for decompression of gas and liquid stool in the immediate postoperative period. It avoids the need for a third operation when used in conjunction with an initial distal ostomy.

Anus, Imperforate↗