• Takuya Shiraishi, Yuji Nishizawa, Mifumi Nakajima, Ryoko Kado, Hiroomi Ogawa, Satoh Naomi, Yohei Owada, Tsuyoshi Enomoto, Shinji Yazawa, Yukihiro Hamahata, Yumi Isogami, Kazuo Kitagawa, Maki Sakamoto, Hiroya Enomoto, Akiko Egawa, Daichi Kitaguchi, Hiro Hasegawa, Koji Ikeda, Yuichiro Tsukada, and Masaaki Ito.
• Department of General Surgical Science, Gunma University Graduate School of Medicine.
• Ann. Surg. 2024 Sep 6.

ObjectiveThis study aimed to understand the effectiveness of regular care in reducing the incidence of severe peristomal skin disorders, as well as to identify their risk factors.Summary Background DataPeristomal skin disorders occur frequently in outpatient settings and require appropriate intervention. It remains, however, to be demonstrated when the need to follow up these patients decreases and whether assessing severity of peristomal skin disorders is useful.MethodsThis prospective, multicenter, observational cohort study was conducted in six regional high-volume Japanese hospitals. The primary endpoint of the study was the effectiveness of regular follow-up in reducing the incidence of severe peristomal skin disorders via a scoring system at a defined regular outpatient visit. Propensity score matching was performed to compare a control group and patients with severe peristomal skin disorders.ResultsIn total, 217 patients between December 2019 and December 2021 were enrolled, and 191 patients were analyzed. Multivariate analysis showed that loop stoma (odds ratio [OR], 5.017; 95% confidence interval [CI], 1.350-18.639; P=0.016) and stoma height of <10 mm (OR, 7.831; 95% CI, 1.760-34.838; P=0.007) were independent risk factors for all peristomal skin disorders. After propensity score matching, the incidence of the disorders was not significantly different between the specified evaluation timing and historical control groups (75.7% vs. 77.2%, P=0.775), and the incidence of the severe disorders based on the ABCD and DET scores (5.9% vs. 19.1%, P<0.001 and 1.5% vs. 29.4%, P<0.001, respectively) was significantly lower in the specified evaluation timing group than in the historical control group.ConclusionRegular peristomal skin disease follow-up and scoring, as well as appropriate stoma care at the stoma outpatient visit did not change the frequency of peristomal skin disease, but severe peristomal skin disorders were prevented. Additionally, risk factors for peristomal skin disorders were found to be height <10 mm and loop stoma.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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