title: Evaluating skin care problems in people with stomas.
abstract: OBJECTIVE
  This study aimed to identify actual and potential peristomal skin problems in relation to the use of different types of stoma appliances and accessories. It also compared ostomists' perceptions of their peristomal skin condition with those of stoma care nurse specialists.
  
  
  BACKGROUND
  Maintaining skin integrity is a basic skill that ensures good stoma management. It is widely accepted that from time to time a patient with a stoma will seek clinical advice about a peristomal skin problem. Little is known about how often patients present with these problems, the clinical course of peristomal skin problems, and how patients manage them.
  
  
  METHODS
  A multi-centred descriptive study was conducted among 80 ostomists. Fieldwork took place over 13 months. The sample was drawn from a UK home care delivery database. Using structured questionnaires, ostomists were interviewed by a stoma care nurse specialist. A digital photograph was taken of their peristomal skin and their answers compared with nurse assessment using the Stoma Care Ostomy Research index scoring system.
  
  
  RESULTS
  Of the interviewees 32% had healthy peristomal skin both via questionnaire and at observation. At observation, 68% were observed to have peristomal skin problems, of whom 44% had irritated skin, 12% had ulcerated skin, 9% had an apparent allergy and 3% had macerated/eroded skin. In addition, 21% had an ill-fitting appliance at observation. Half (50%) were observed to have a parastomal hernia, although only 24% reported having one. These findings demonstrate significant differences between the perception of skin problems among ostomists and actual skin problems observed by stoma care nurse specialists.
  
  
  CONCLUSIONS
  Peristomal skin problems are common among ostomists. The difference between ostomists' and nurses' perceptions of peristomal skin condition led to the identification of educational needs for the new ostomist. Education and regular follow-up by the stoma care nurse specialist is imperative.
authors.affiliation: Burdett Institute of Gastrointestinal Nursing in partnership with King's College London and St Mark's Hospital, Harrow.
authors.forename: Julia
authors.initials: J
authors.lastname: Williams
authors.forename: Brandon
authors.initials: B
authors.lastname: Gwillam
authors.forename: Norma
authors.initials: N
authors.lastname: Sutherland
authors.forename: Jane
authors.initials: J
authors.lastname: Matten
authors.forename: Julie
authors.initials: J
authors.lastname: Hemmingway
authors.forename: Helen
authors.initials: H
authors.lastname: Ilsey
authors.forename: Mary
authors.initials: M
authors.lastname: Somerville
authors.forename: Angela
authors.initials: A
authors.lastname: Vujnovich
authors.forename: Stephanie
authors.initials: S
authors.lastname: Day
authors.forename: Caroline
authors.initials: C
authors.lastname: Redmond
authors.forename: Caroline
authors.initials: C
authors.lastname: Cowin
authors.forename: Kathy
authors.initials: K
authors.lastname: Fox
authors.forename: Theresa
authors.initials: T
authors.lastname: Parker
mesh_terms: D006801:Humans; D012871:Skin Diseases / Q000209:etiology / Q000451:nursing*; D054047:Surgical Stomas; D006113:United Kingdom