N Runkel1, W Droste2, B Reith3, E C Jehle4, S Benz5, M Birk6, G Staib7, J Romankiewicz8, F Hartkopf9, M Jooß10. 1. Klinik für Allgemein- und Viszeralchirurgie, Schwarzwald-Baar-Klinikum, Villingen-Schwenningen, Deutschland. norbert.runkel@sbk-vs.de. 2. Fachgesellschaft Stoma, Kontinenz und Wunde e. V., Selm, Deutschland. Werner.droste@fgskw.org. 3. Klinik für Allgemein- und Viszeralchirurgie, Agaplesion Diakonie Kliniken Kassel, Diakonissen-Krankenhaus, Kassel, Deutschland. b.reith@diako-kassel.de. 4. Klinik für Allgemein- und Viszeralchirurgie, Oberschwabenklinik, Krankenhaus St. Elisabeth, Ravensburg, Deutschland. ekkehard.jehle@oberschwabenklinik.de. 5. Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Klinikverbund Südwest, Kliniken Böblingen, Böblingen, Deutschland. s.benz@klinikverbund-suedwest.de. 6. Wund- und Stomatherapeutin, Schwarzwald-Baar-Klinikum, Villingen-Schwenningen, Deutschland. mechthilde.birk@sbk-vs.de. 7. Dermatologische Praxis, Esslingen, Deutschland. gyde.staib@t-online.de. 8. Pflegeexpertin Stoma, Wunde, Kontinenz, Fa.Publicare GmbH, Düsseldorf, Deutschland. jolanthe.romankiewicz@publicare-gmbh.de. 9. IlCO Landesverband Baden Württemberg, Remshalden, Deutschland. hartkopf-remshalden@t-online.de. 10. ILCO LV-Baden Württemberg, Berglen, Deutschland. fam.jooss@t-online.de.
Abstract
BACKGROUND: Peristomal skin lesions are frequent complications of ostomy; however, there is no generally accepted nomenclature and classification system. OBJECTIVE: An interdisciplinary German expert panel (GESS) composed of ten members, developed an innovative semiquantitative classification system for peristomal skin lesions for further stratification of ostomy therapy. This score is based on criteria which can be assessed by stomal therapists and treating physicians. RESULTS: The new peristomal skin lesion score grades three categories: lesion (L), status of ostomy (S) and disease (D). The L category describes the integrity of the skin as normal (L0), lesion with sustained integrity of skin (L1), integrity destroyed (L2) and local infection (L3). The S category rates the complexity of ostomy therapy as normal (S0), increased (S1) and high but not sufficiently effective (S2). The additional letters for categorization O. R. P. H. E. US describe anatomical pathologies of the stoma itself: ostomy stenosis (O), retraction (R), prolapse (P), hernia (H), edema (E) and unfavorable site (US). A systemic disorder is either absent (D0), irrelevant (D1) or relevant (D2). The LSD score is the basis for a management algorithm. CONCLUSION: The LSD score is comprehensive, standardized and holistic. Its straightforward use by health professionals can improve the consistency of the description of skin lesions and enhance the quality of ostomy therapy.
BACKGROUND: Peristomal skin lesions are frequent complications of ostomy; however, there is no generally accepted nomenclature and classification system. OBJECTIVE: An interdisciplinary German expert panel (GESS) composed of ten members, developed an innovative semiquantitative classification system for peristomal skin lesions for further stratification of ostomy therapy. This score is based on criteria which can be assessed by stomal therapists and treating physicians. RESULTS: The new peristomal skin lesion score grades three categories: lesion (L), status of ostomy (S) and disease (D). The L category describes the integrity of the skin as normal (L0), lesion with sustained integrity of skin (L1), integrity destroyed (L2) and local infection (L3). The S category rates the complexity of ostomy therapy as normal (S0), increased (S1) and high but not sufficiently effective (S2). The additional letters for categorization O. R. P. H. E. US describe anatomical pathologies of the stoma itself: ostomy stenosis (O), retraction (R), prolapse (P), hernia (H), edema (E) and unfavorable site (US). A systemic disorder is either absent (D0), irrelevant (D1) or relevant (D2). The LSD score is the basis for a management algorithm. CONCLUSION: The LSD score is comprehensive, standardized and holistic. Its straightforward use by health professionals can improve the consistency of the description of skin lesions and enhance the quality of ostomy therapy.