The Use of a Stoma Rod/Bridge to Prevent Retraction: A Systematic Review. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Gialamas, Eleftherios; Meyer, Jeremy; Abbassi, Ziad; Popeskou, Sotirios; Buchs, Nicolas Christian; Ris, Frédéric
• Is Part Of: Journal of WOCN. Volume 48:Issue 1(2021)
• Publication Date: 2021-01
• Subjects: Defunctioning stoma -- Loop ileostomy -- Loop stoma -- Stoma bridge -- Stoma retraction -- Stoma rod; Abdomen -- Surgery -- Periodicals; Abdomen -- Wounds and injuries -- Nursing -- Periodicals; Bedsores -- Nursing -- Periodicals; Fecal incontinence -- Nursing -- Periodicals; Enterostomy -- Nursing -- Periodicals; Urinary incontinence -- Nursing -- Periodicals; 610.73
• DOI: 10.1097/WON.0000000000000730
• Languages: English
• ISSNs: 1071-5754

Abstract

Abstract : PURPOSE: We evaluated evidence related to the use of a rod (bridge) to prevent stoma retraction during loop ostomy construction. METHODS: We completed a systematic review of the literature. We searched MEDLINE, EMBASE, and COCHRANE databases up to December 4, 2019. We posed the following question based on a PICO format. Do adult patients undergoing ostomy surgery experience less stomal retraction when compared to patients managed without placement of a stoma rod? FINDINGS: Our initial search returned 182 articles; after reading studies in full, 5 articles were identified that collectively enrolled 1058 participants. Four studies were randomized controlled trials and one was a prospective cohort study. Meta-analysis could not be performed because of the small number of studies and the heterogeneity of outcomes measurements. The incidence of stoma retraction ranged between 0%-8% in patients managed with a rod and 0.78%-8.2% in patients with no rod. The number of reported adverse events was low. Placement of a stoma rod was associated with more adverse outcomes than in patients managed without a rod. Adverse events included local edema, stoma necrosis, skin necrosis, peristomal moisture-associated skin damage (irritant dermatitis), peristomal abscess, bleeding, and mucocutaneous separation. CONCLUSIONS: Stoma rod does not seem to reduce the risk of stoma retraction and might result in other adverse events. IMPLICATIONS: We recommend avoidance of stoma rod/bridge placement during ostomy surgery. Abstract : The NCPD test for this article is available online only at the journal website, jwocnonline.com, and the test can be taken online at NursingCenter.com.