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Postoperative stomikomplikasjoner

Postoperative stomikomplikasjoner. Mette Hammer Stomisykepleier Akershus Universitetssykehus. Studier viser at de fleste komplikasjoner oppstår innen 2-3 uker etter stomianleggelsen Risikofaktorer: Stomitype, lengde, BMI, ø-hjelpsoperasjon, manglende preoperativ markering

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Postoperative stomikomplikasjoner

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  1. Postoperative stomikomplikasjoner Mette Hammer Stomisykepleier Akershus Universitetssykehus

  2. Studier viser at de fleste komplikasjoner oppstår innen 2-3 uker etter stomianleggelsen Risikofaktorer: Stomitype, lengde, BMI, ø-hjelpsoperasjon, manglende preoperativ markering De som var preoperativt markert hadde signifikant lavere risiko for å utvikle stomiproblemer postoperativt enn de som ikke var markert (Parmar et al 2010) Gjennomsnittsvekten var signifikant høyere hos pasienter som fikk komplikasjoner med stomien, og gjennomsnittslengden på stomien var signifikant kortere hos de med komplikasjoner (Parmar et al 2010) Parmar et al 2010. A prospective audit of early stoma complications in colorectal cancer treatment throughout the Greater Manchester and Cheshire colorectal cancer network. The Association of Coloproctology of Great Britain and Ireland. 13, 935-938 Persson et al 2009. Stoma-related complications and stamasize- a 2-year follow up. The Association of Coloproctology of Great Britain and Ireland. 12, 971-976 Shabbir, Britton 2009. Stoma complications: a literature overview. The Association of Coloproctology of Great Britain and Ireland 12, 958-964

  3. Mucocutan separasjon5%-25% Observasjoner: Lyon, Smith 2010. Abdominal Stomas and their Skin Disorders. Informa Healthcare Parmar et al 2010. A prospective audit of early stoma complications in colorectal cancer treatment throughout the Greater Manchester and Cheshire colorectal cancer network. The Association of Coloproctology of Great Britain and Ireland. 13, 935-938 Persson et al 2009. Stoma-related complications and stamasize- a 2-year follow up. The Association of Coloproctology of Great Britain and Ireland. 12, 971-976 Shabbir, Britton 2009. Stoma complications: a literature overview. The Association of Coloproctology of Great Britain and Ireland 12, 958-964 Delvis eller fullstendig, overflatisk eller dyp separasjon i en mucocutan overgang Smerte/ ubehag 3

  4. Mucocutan separasjon Årsaker Behandling Cottam et al 2006. Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery. The Association of Coloproctology of Great Britain and Ireland. 9, 834-838 Lyon, Smith 2010. Abdominal Stomas and their Skin Disorders. Informa Healthcare Kirurgisk teknikk (dårlig suturering, for stort hull i bukveggen) Nedsatt vevstilheling (ernæring, DIA, kortison, preopr.stråling) Konveksitet brukt postopr. Infeksjon Fylle/ klippe utenfor defekten Såret gror godt selv med avføring i To-delt bandasje 4

  5. Nekrose Cottam et al 2006. Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery. The Association of Coloproctology of Great Britain and Ireland. 9, 834-838 Lyon, Smith 2010. Abdominal Stomas and their Skin Disorders. Informa Healthcare Persson et al 2009. Stoma-related complications and stamasize- a 2-year follow up. The Association of Coloproctology of Great Britain and Ireland. 12, 971-976 Shabbir,Britton 2009. Stoma complications: a literature overview. The Association of Coloproctology of Great Britain and Ireland 12, 958-964 1%-20% Sees oftest hos de med colostomi, spesielt hvis venstre colon arterien er ligert

  6. Nekrose Observasjoner: Cottam et al 2006. Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery. The Association of Coloproctology of Great Britain and Ireland. 9, 834-838 Lyon, Smith 2010. Abdominal Stomas and their Skin Disorders. Informa Healthcare Blå, svart, grå farge på slimhinnen, helt eller delvis Stomien blir tørr og ru Viktig å observere hvor dypt nekrosen går 6

  7. Nekrose Årsak Behandling Cottam et al 2006. Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery. The Association of Coloproctology of Great Britain and Ireland. 9, 834-838 Lyon, Smith 2010. Abdominal Stomas and their Skin Disorders. Informa Healthcare Shabbir,Britton 2009. Stoma complications: a literature overview. The Association of Coloproctology of Great Britain and Ireland 12, 958-964 Kirurgisk teknikk (drag i mesenteriet) Dårlig blodsirkulasjon Observasjon Informere lege Kirurgisk revisjon Pas. må følges opp med tanke på retraksjon eller stenose 7

  8. Retrahert stomi 10%- 40% Retraksjon av stomien forekommer oftere hos pasienter med BMI over 21 (Shabbir et al 2009). Hvis stomien er lavere enn 10mm 48t etter operasjon er det 35% sjanse for at det kan oppstå problemer (Cottam et al 2007). Arumugam et al 2003. A prospetive audit of stomas- analysis of risk factors and complications and their management. Coloretctal Disease5, 49-52 Cottam et al 2006. Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery. The Association of Coloproctology of Great Britain and Ireland. 9, 834-838 Lyon, Smith 2010. Abdominal Stomas and their Skin Disorders. Informa Healthcare Parmar et al 2010. A prospective audit of early stoma complications in colorectal cancer treatment throughout the Greater Manchester and Cheshire colorectal cancer network. The Association of Coloproctology of Great Britain and Ireland. 13, 935-938 Shabbir, Britton 2009. Stoma complications: a literature overview. The Association of Coloproctology of Great Britain and Ireland 12, 958-964

  9. Retrahert stomi Observasjoner: Lyon, Smith 2010. Abdominal Stomas and their Skin Disorders. Informa Healthcare Shabbir, Britton 2009. Stoma complications: a literature overview. The Association of Coloproctology of Great Britain and Ireland 12, 958-964 Stomien ligger i hudnivå eller under hudnivå 9

  10. Retrahert stomi Årsak Behandling Cottam et al 2006. Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery. The Association of Coloproctology of Great Britain and Ireland. 9, 834-838 Lyon, Smith 2010. Abdominal Stomas and their Skin Disorders. Informa Healthcare For kort krøs For tidlig fjerning av stav i bøylestomier Kirurgisk konstruksjon Vektøkning Arrvev som følge av nekrose eller mucocutan seperasjon Kirurgi En-delt bandasje evt. konveks plate Stomibelte Behandle sår hud med krystallfiolett 0,5% og sårpulver Beskyttelsesfilm 10

  11. Takk for oppmerksomheten

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