Incidence of complications of the stoma and peristomal skin among individuals with colostomy, ileostomy, and urostomy: a systematic review.

The objectives of this systematic review were to assess the incidence of complications of the stoma and peristomal skin, synthesize possible reasons for variability in results, and make recommendations for future research. Twenty-one studies published in English between January 1990 and August 2007, with a prospective design that reported the number of complications of the stoma or peristomal skin among participants with colostomy, ileostomy, or urostomy, were identified. The types of complications most commonly reported were retraction, hernia, prolapse, peristomal skin problems, and necrosis. Incidence rates varied widely among studies, even when the same types of complications were measured. Inadequate reporting of attrition, the number of participants at each phase of analysis, and missing data were common problems. Differences among study durations, the absence of definitions of complications, and failure to describe how complications were evaluated contributed to variability in reported complication rates. More studies are needed that use a prospective design, consistent operational definitions, and valid and reliable measurement methods. These recommendations will help increase the availability of standardized data to make comparisons among studies possible.