The Use of a Stoma Rod/Bridge to Prevent Retraction: A Systematic Review.

Gialamas, Eleftherios; Meyer, Jeremy; Abbassi, Ziad; Popeskou, Sotirios; Buchs, Nicolas Christian; Ris, Frédéric

PURPOSE:

We evaluated evidence related to the use of a rod (bridge) to prevent stoma retraction during loop ostomy construction.

METHODS:

We completed a systematic review of the literature. We searched MEDLINE, EMBASE, and COCHRANE databases up to December 4, 2019. We posed the following question based on a PICO format. Do adult patients undergoing ostomy surgery experience less stomal retraction when compared to patients managed without placement of a stoma rod?

FINDINGS:

Our initial search returned 182 articles; after reading studies in full, 5 articles were identified that collectively enrolled 1058 participants. Four studies were randomized controlled trials and one was a prospective cohort study. Meta-analysis could not be performed because of the small number of studies and the heterogeneity of outcomes measurements. The incidence of stoma retraction ranged between 0%-8% in patients managed with a rod and 0.78%-8.2% in patients with no rod. The number of reported adverse events was low. Placement of a stoma rod was associated with more adverse outcomes than in patients managed without a rod. Adverse events included local edema, stoma necrosis, skin necrosis, peristomal moisture-associated skin damage (irritant dermatitis), peristomal abscess, bleeding, and mucocutaneous separation.

CONCLUSIONS:

Stoma rod does not seem to reduce the risk of stoma retraction and might result in other adverse events. IMPLICATIONS We recommend avoidance of stoma rod/bridge placement during ostomy surgery.

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