3.8 Review

Current Management of Intestinal Stomas and Their Complications

Journal

JOURNAL OF THE ANUS RECTUM AND COLON
Volume 4, Issue 1, Pages 25-33

Publisher

JAPAN SOC COLOPROCTOLOGY
DOI: 10.23922/jarc.2019-032

Keywords

Stoma complications; perioperative management; early complications; late complications; stoma care

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Inappropriate stoma site, improper management of stoma, and stoma complications lead to diminished quality of life of ostomates. Healthcare professionals involved in stoma creation and/or care should have the fundamental and updated knowledge of the management of stomas and their complications. This review article consists of the following major sections: principles of perioperative patient management, early complications, and late complications. In the principles of perioperative patient management section, the current concepts and trends in preoperative education, stoma site marking, postoperative education, and patient educational resources are discussed. In the early complications section, we have focused on the etiology and current management of ischemia/necrosis, fluid and electrolyte imbalances, mucocutaneous separation, and retraction. In the late complications section, we have focused on the etiology and current management of parastomal hernia, stoma prolapse, parastomal varices, and pyoderma gangrenosum. Pre- and postoperative patient education facilitates the patient's independence in stoma care and resumption of normal activities. Healthcare providers should have basic skills and updated knowledge on the management of stomas and complications of stomas, to act as the first crisis manager for ostomates.

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