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The Impact of Preoperative Stoma Site Marking on the Incidence of Complications, Quality of Life, and Patient’s Independence

Person, Benjamin M.D.1; Ifargan, Ruth M.S.N., R.N., C.W.O.C.N.1; Lachter, Jesse M.D.2; Duek, Simon D. M.D.1; Kluger, Yoram M.D.1; Assalia, Ahmad M.D.1

Diseases of the Colon & Rectum: July 2012 - Volume 55 - Issue 7 - p 783–787
doi: 10.1097/DCR.0b013e31825763f0
Original Contribution

BACKGROUND: Preoperative stoma site marking and counseling aim to improve patients’ rehabilitation and adaptation to a new medical condition. Objective studies are needed to provide evidence of the impact of care by stoma therapists. Key quality indicators include patients’ quality of life, independence, and complication rates as affected by the variable modes of stoma site marking and planning.

OBJECTIVE: The aim of this study was to evaluate the impact of preoperative stoma site marking on patients’ quality of life, independence, and complication rates.

DESIGN: A validated stoma quality-of-life questionnaire was used as the main assessment tool. Complications were noted on regular postoperative visits.

SETTING: This is a single-center, clinical study. The study was conducted at the Rambam Health Care Campus in Haifa, Israel. Rambam Health Care Campus is a tertiary university hospital.

PATIENTS: All patients who underwent an elective stoma creation between 2006 and 2008 were included.

MAIN OUTCOME MEASURES: Evaluated parameters included demographics, stoma type, marking status, complication rates, quality of life, and independence parameters.

RESULTS: One hundred five patients (60 men and 45 women) were included, of whom 52 (49.5%) were preoperatively marked and 53 (50.5%) were not marked. Sixty stomas (57%) were permanent, and 45 (43%) stomas were temporary. The quality of life of patients whose stoma sites were preoperatively marked was significantly better than that of the unmarked patients (p < 0.05 in 18 of 20 items), their independence parameters were significantly better, and their complication rates significantly lower. All of these results were significant irrespective of the stoma type.

CONCLUSIONS: Preoperative stoma site marking is crucial for improving patients’ postoperative quality of life, promoting their independence, and reducing the rates of postoperative complications. The role of the enterostomal therapist is very important in the ostomates’ pre- and postoperative care.

Department of General Surgery, Rambam Health Care Campus, Haifa, Israel

Institute of Gastroenterology, Rambam Health Care Campus, Haifa, Israel

Funding/Support: The statistical analysis performed in this study was financially supported by Coloplast, Israel.

Financial Disclosures: None reported.

Correspondence: Benjamin Person, M.D., Department of General Surgery, Rambam Health Care Campus, P.O.B. 9602, Haifa 31096, Israel. E-mail:

© 2012 The American Society of Colon and Rectal Surgeons