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Paediatric gastrostomy stoma complications and treatments: A rapid scoping review.

Authors
  • Townley, Ashleigh1
  • Wincentak, Joanne1
  • Krog, Kim2, 3
  • Schippke, Julia1
  • Kingsnorth, Shauna1, 4, 5, 6
  • 1 Evidence to Care, Teaching & Learning Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada. , (Canada)
  • 2 Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada. , (Canada)
  • 3 Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada. , (Canada)
  • 4 Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada. , (Canada)
  • 5 Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada. , (Canada)
  • 6 Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada. , (Canada)
Type
Published Article
Journal
Journal of Clinical Nursing
Publisher
Wiley (Blackwell Publishing)
Publication Date
Apr 01, 2018
Volume
27
Issue
7-8
Pages
1369–1380
Identifiers
DOI: 10.1111/jocn.14233
PMID: 29266535
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To provide a scoping review of the types of treatments used to address paediatric skin-related stoma complications specific to infection, hypergranulation and gastric leakage, and explore their effectiveness and indications for use. Stoma-related complications can be a common occurrence for children with gastrostomy (G) and gastrojejunostomy (GJ) tubes. Nurses require guidance to inform decision-making of the broad spectrum of treatments used in clinical practice. A scoping review using a rapid review approach. Working with a multidisciplinary health professional team, search terms were generated. A systematic search of CINAHL, MEDLINE and EMBASE databases was completed, coupled with an Internet search to identify relevant clinical practice guidelines and hand searching of citation lists. Eligible articles were peer-reviewed English publications, focused on paediatric populations aged 18 years and under, dating from 2002-2016 and described complications and treatment approaches related to G- and GJ-tube stomas. Pertinent information was extracted using a standardised template, and a narrative synthesis approach was used to analyse the data. Twenty-five articles were included in this review. Study designs varied, and complication management was often a secondary focus. A broad spectrum of treatments was used to manage each complication type. There was a lack of consensus on lines of therapy; however, a stepwise approach was often used for complication management, particularly for infections. The evidence on the comparative effectiveness of different treatment strategies of skin-related gastrostomy stoma complications in paediatric practice is sparse. Current evidence is generally limited to expert opinions. Future studies examining efficacy of treatments and their indications for use with children are warranted. Effective management of skin-related stoma complications is important to maintain health and wellness among children who rely on G- and GJ-tubes for nutrition support. © 2017 John Wiley & Sons Ltd.

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