Cirugía mutilante por metástasis peneano-escrotal de adenocarcinoma rectal / No disponible

Ante la excepcionalidad de un paciente con presencia de múltiples estomas (colostomía, cistostosmía y nefrostomía), este trabajo indaga cómo le afecta su situación, y se completa con los propios cuidados de enfermería en pacientes ostomizados.La valoración del paciente se realizó a partir de los patrones funcionales de Marjory Gordon, planteando un plan de cuidados individualizado. La realización de un proceso de atención de enfermería (PAE) sirvió de guía para realizar los cuidados de manera dinámica, deliberada y ordenada. Además, se le facilitaron cuestionarios para valorar la esfera emocional, lo que ayudó a entender las debilidades del paciente.En cuanto al proceso de curación de las heridas quirúrgicas y los estomas, un seguimiento cercano, así como el uso de los materiales apropiados e involucrar al paciente y familiares en dichos cuidados, disminuye las complicaciones asociadas

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Clinical evaluation of the multifunctional suprapubic catheter in patients requiring permanent suprapubic cystostomy: A prospective randomised trial in a single centre.

AIMS AND OBJECTIVES: To assess the clinical effect of the multifunctional suprapubic catheter (MSC) on occurrence of cystospasm, catheter occlusion, the catheter-related urinary tract infection and remission of overactivity bladder, by comparing with the conventional suprapubic catheter (CSC) in patients with permanent suprapubic cystostomy. BACKGROUND: The conventional suprapubic catheter usually presents with high incidence of catheter-associated complications. DESIGN: A prospective randomised clinical trial in a single centre. METHODS: Between January 2014 and January 2015, a total of 91 consecutive patients with permanent suprapubic cystostomy were prospectively randomised into two groups: the MSC group (n = 43) and CSC group (n = 48). RESULTS: Our results showed that the total times of cystospasm in the MSC group were significantly less than that in the CSC group during the follow-up time (p < .001). In addition, the mean spasmodic duration per time in the MSC group was significantly shorter than that in the CSC group (p < .001). Besides, catheter occlusions were observed in 23 (25.27%) patients, including 5 (11.63%) in the MSC group and 18 (37.50%) in the CSC group (p = .005). The lower rate of positive urine culture was also found in the MSC group but with no significant difference (p = .540). Furthermore, the urodynamic measurement data demonstrated that the patients in the MSC group had a greater remission rate of overactivity bladder after catheter change (p < .001). CONCLUSIONS: The present data showed that the multifunctional suprapubic catheter could significantly reduce the incidence of catheter occlusion, ameliorate the symptom of cystospasm and relieve the overactivity bladder, but have no influence on the catheter-related urinary tract infection. RELEVANCE TO CLINICAL PRACTICE: The application of our self-devised multifunctional suprapubic catheter may result in better management of the patients with permanent suprapubic cystostomy.

Evaluation of a new ostomy mouldable seal: an international product evaluation.

A new mouldable seal, Brava® Protective Seal, was evaluated by patients on aspects related to residue, durability, and preference. A total of 135 patients from four countries participated (Denmark, Germany, Japan and the USA) and the new product was compared to the patients' usual pouching systems. Less residue and easier skin cleansing was observed, which may benefit patient quality of life. The possible benefits of less residue for peristomal skin health need further investigation.

Revisión del protocolo del sondaje vesical. ¿Y ahora qué? / No disponible

Siguiendo las nuevas líneas de acción en materia de seguridad propuestas por Osakidetza en relación con la disminución de infecciones del tracto urinario asociadas a catéteres, y continuando con el interés creciente por una práctica clínica basada en la evidencia, se ha llevado a cabo una actualización del protocolo del sondaje vesical. Tras una exhaustiva búsqueda bibliográfica se han determinado puntos clave en el procedimiento del sondaje vesical y se están estudiando estrategias para difundir este protocolo. En la práctica se verán reflejadas en acciones dirigidas a evitar sondajes innecesarios, retirada precoz de las sondas, técnicas asépticas en la inserción, correcto mantenimiento, seguimiento de ITU relacionadas con el sondaje. Todo esto es un proceso sin concluir que nos va a llevar a adaptarnos a unas recomendaciones e intervenciones enfermeras basadas en la mejor evidencia

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Urostomy management in the community.

Around 11 000 people in the UK have a urostomy. A urostomy is now usually carried out for bladder cancer. Most urostomists are older men and around half require assistance with routine care. Complications such as parastomal skin soreness are common. Community nurses can work with urostomists and formal and informal carers to encourage and enable the person to manage their urostomy independently whenever possible and provide support, advice and help when complications occur. This article provides an overview of effective care and possible complications.

Decreasing suprapubic tube-related injuries: results of case series and comprehensive literature review.

Bowel-related injuries are known complications of suprapubic tube (SPT) catheterization placement. A literature review was conducted to determine identifiable risk factors for bowel injury. Results on the analysis of 25 cases are presented along with a proposed algorithm to aid in choosing between open, percutaneous, and image-guided methods of placement.

Validation of the urostomy education scale: the European experience.

Bladder cancer is the fourth most common cancer among European males. Once diagnosed with muscle invasive bladder cancer, a radical cystectomy is the first line treatment, which results in a urostomy. The placement of a urostomy and the care required impacts the patient's life. Previous research validated the Urostomy Education Scale as the first standardized tool capable of documenting the patients' level of stoma self-care skills and useful to guide patient education interventions. A Danish-Dutch Fellowship was established to support and provide further evidence of applicability of the Urostomy Education Scale.

[Intermittent urinary catheterization and collaboration between the stoma nurse and psychologist]. / Sondage urinaire intermittent et collaboration infirmière stomathérapeute/psychologue.

Intermittent urinary catheters can be prescribed in cases of urogenital disorders. The child and the family undergo a long process to adapt and learn a new way of life requiring regular stoma care. The stoma nurse specialist and psychologist work together to ensure the follow-up and therapeutic education of the children and their families as well as the coordination of the different partners involved in helping the child gain their autonomy.

Providing information and advice on diet to stoma patients.

The community nurse will encounter many queries and requests for advice in the work environment. This article offers information on diet related to the stoma. Specific advice for the three different types of stoma, and for certain situations that might arise after the ostomate (person with a stoma) is discharged home, is provided. Much of the advice is common sense, but it might prevent the use of medication such as laxatives. Nutrition is essential for recovery following surgery and in the long-term. By using the information provided, the community nurse can give better care to this group of patients.

Ins and outs of suprapubic catheters--a clinician's experience.

In today's evolving health care field, outpatient procedures are becoming more commonplace. Many patients with suprapubic catheters are now being seen in outpatient or home care settings. Addressing the educational needs of patients, family members, and nursing staff is now more important than ever for successful patient suprapubic catheter management. A basic understanding of how these catheters are initially placed is essential for proper care and avoidance of possible complications. This review of initial placement of suprapubic catheters and post-insertion care is based on one clinician's experience and practice at a local hospital in Pennsylvania.

Matching the skin barrier to the skin type.

Peristomal skin problems are thought to be common (Herlufsson et al, 2006; Williams et al, 2010), and can interfere with the security of stoma products. Stoma patients are reliant on the integrity of their peristomal skin to maintain a normal lifestyle. Bekkers et al (1996) highlighted that, if the peristomal skin becomes damaged, it not only affects the person physically, but also psychologically, ultimately prolonging rehabilitation and adaptation to the stoma. Therefore, it can be concluded that maintaining skin integrity is a basic and essential skill in ensuring good stoma management. This article explores the assessment of four stoma patients, highlighting the importance of matching their skin type with their skin barrier for optimum skin protection. The patients have kindly agreed for their case studies to be published as a means of informing others. All names have been changed in line with Nursing and Midwifery Council (2010) guidelines to maintain patient confidentiality. This article was originally presented at the World Council of Enterostomal Therapists' (WCET) annual conference in 2010, receiving first prize at poster presentations.

An overview of suprapubic catheter care in community practice.

This paper gives a broad overview of suprapubic catheterization. Community nurses can often feel they lack experience with suprapubic catheter general care and routine changes. This paper sets out the advantages and disadvantages of suprapubic catheters, the procedure for routine change and the golden rules for general care. The paper contains an introduction on trouble shooting.

Insertion, care and management of suprapubic catheters.

A suprapubic catheter may be used to drain the bladder of urine as an alternative to an indwelling urethral catheter. It can be inserted as a temporary or permanent measure in patients with urinary dysfunction or if initial urethral catheter insertion or recatheterisation is problematic. This article discusses insertion of suprapubic catheters, management and care, including changing suprapubic catheters, drainage systems and the importance of patient education.