Authors

Marta Pérez García1, Mª Antonia Ramos Mateos2

Position

1Enfermera. Experta en Estomaterapia. Unidad de Hospitalización de Cirugía General y Digestiva del Hospital Universitario Ramón y Cajal. Madrid2Enfermera. Máster en Investigación en Ciencias de la Enfermería. Unidad de Hospitalización de Cirugía General y Digestiva del Hospital Universitario Ramón y Cajal. Madrid

Contact address

Mª Antonia Ramos Mateos. C/ Mirador del Prado, 6-1º A. 28400 Collado Villalba (Madrid)

Contact email: toi_ramos@yahoo.es

Abstract

Objective: to learn about the evidence available on the strategies to be followed by nursing professionals in order to prevent or reduce the incidence of parastomal hernia.
Method: a narrative review through bibliographic search, in English, Spanish and Portuguese, in scientific databases, specialized journals, books or guidelines and web resources, following the pre-designed inclusion criteria. The publications found were evaluated and their recommendations were classified according to the CTFPHC (Canadian Task Force on Preventive Health Care).
Outcomes: six articles were selected: three presented II-3 evidence with Grade of Recommendation (GR) C; one presented III evidence with GR C; one presented II-2 evidence with GR B; and the remaining one was a bibliographic review. The perception from these studies seems to be that a Prevention Program implemented from the time of hospital discharge will reduce the incidence and costs. The Non-Invasive Prevention Program includes a reduction in manoeuvres increasing abdominal pressure (coughing, carrying weight) during the first three months after surgery, followed by hypopressive abdominal exercises for strengthening the abdominal muscles, and use of clothing and/or devices that will help to homogenize the abdominal pressure (such as a non-fenestrated abdominal belt) immediately after the surgical procedure.
Conclusions: there is little evidence about the strategies to be followed by nurses to prevent or reduce the incidence of parastomal hernia. The articles analyzed presented low levels of evidence. The highest level found was II-2 in one single study with Grade of Recommendation B; therefore, outcomes must be regarded with caution until there are new studies available.

Keywords:

ostomy; parastomal hernia; prevention; nursing intervention

Versión en Español

Título:

Prevención de la aparición de hernia paraestomal