Managing high-output stomas: module 3 of 3

British Journal of Nursing : BJN
Rebecca Slater, S M Gabe

Abstract

Enterocutaneous fistulae (ECF) and high-output stomas are challenging to manage, owing to the large volume of loss that may result in severe dehydration, electrolyte imbalances, malnutrition and sepsis. It is imperative that this group of patients receive adequate nutrition, as malnutrition and sepsis are the leading cause of death. Treatment is complex and based on various situations, treatment can be medical/conservative management or surgical. Depending on the site of the fistula and the length of residual intestine contributing as the cause of a high output stoma with the nutritional status of the patient, clinicians have to decide whether parenteral nutrition (PN) or enteral nutrition (EN) should be established. As previously discussed in module 1 and 2 (Gabe, 2013; Gabe and Slater, 2013) the theme of nutritional management and appliance/accessory selection to manage patients with ECF and high output stomas was outlined. The aim of providing an understanding of the nutritional needs and the practicalities of maintaining appliance adherence, and in turn, a reduction in the breakdown of the peri-stomal skin was described. Module 3 aims to provide understanding for the reader that may encounter patients undergoing surgery for...Continue Reading

References

Jul 1, 1983·World Journal of Surgery·J E Fischer
Oct 1, 1996·The Surgical Clinics of North America·S M Berry, J E Fischer
Dec 25, 2003·The Proceedings of the Nutrition Society·Jeremy M D Nightingale
Dec 25, 2003·The Proceedings of the Nutrition Society·G L Carlson
May 6, 2004·British Journal of Nursing : BJN·Jennie Burch
Sep 14, 2007·British Journal of Nursing : BJN·Jo Sica, Jennie Burch
Oct 2, 2007·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Maggie HamJonathan Kaunitz
Dec 11, 2007·Lancet·Alastair Forbes
May 17, 2013·British Journal of Nursing : BJN·Simon Gabe, Rebecca Slater

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Citations

Jul 22, 2014·British Journal of Nursing : BJN·Alison McDonald

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