Comparison of Standardized Peristomal Skin Care and Crusting Technique in Prevention of Peristomal Skin Problems in Ostomy Patients

PURPOSE: This study was performed to compare the effects of standardized peristomal skin care (SPSC) and crusting technique (CT) on the peristomal skin of ostomates. SPSC was developed by a consensus among the expert group based on a comprehensive review of the relevant literature and hospital protocols. METHODS: A randomized controlled pilot trial with 2 parallel arms was used. A total of 81 ostomates, who were recruited from a tertiary hospital, completed the baseline, 1-month, 2-month, and 3-month follow-up (SPSC group, n=45; CT group, n=36). SPSC consisted of water cleansing and direct application of ostomy appliances. CT involved crusting hydrocolloid powder and patting with water sponge or protective barrier liquid film. The outcomes of the study were assessed by skin problems, such as discoloration, erosion and tissue overgrowth; the domains of the evaluation tool used in examining the peristomal skin. A generalized estimating equation model was used to examine the effects according to time and group. RESULTS: In both SPSC and CT groups, the likelihood of occurrence of discoloration (OR, 1.99; 95% CI, 1.61-2.46), erosion (OR, 1.87; 95% CI, 1.55-2.25) and tissue enlargement (OR, 1.94; 95% CI, 1.36-2.77) increased with time. There was no significant difference in discoloration between the groups, whereas the probability of erosion (OR, 0.38; 95% CI, 0.16-0.89) and tissue overgrowth (OR, 0.09; 95% CI, 0.02-0.55) was lower in the SPSC group than in CT group. CONCLUSION: SPSC was sufficient in preventing peristomal skin problems of ostomates compared to the CT.

Utilidade do pente metálico com dentes microcanaliculados no diagnóstico da pediculose / Metal microchanelled fine-toothed comb use in the diagnosis of pediculosis

Fundamentos: Os métodos para diagnosticar Pediculus humanus var. capitis são controvertidos e a maioria dos estudos tem usado o exame visual direto. Objetivos: O objetivo deste estudo foi comparar a eficácia no diagnóstico do exame visual direto em contraposição ao uso do pente metálico de aço com dentes microcanaliculados. Métodos: Investigaram-se 946 crianças e adolescentes de quatro a 19 anos. O cabelo de cada criança foi examinado duas vezes, para detectar infestação pelos diferentes estádios, por meio da observação visual direta e com o pente metálico. Resultados: O diagnóstico visual apontou infestação em 30,7 por cento dos casos, enquanto que o pente metálico indicou um resultado de 51,5 por cento. O sexo feminino foi o mais acometido, de acordo com ambos os métodos. As formas parasitárias detectadas com o exame visual direto foram: somente piolhos (adultos e/ou ninfas); 1,4 por cento; somente lêndeas vivas, 64,8 por cento; e lêndeas vivas mais piolhos, 33,8 por cento; com o pente metálico, foram 6,4 por cento, 23,6 por cento e 70 por cento, respectivamente. A média de tempo para descobrir um piolho foi de 57 segundos com o pente metálico e de 116,4 segundos com a observação visual direta. Conclusões: O diagnóstico é duas vezes mais rápido e 3,6 vezes mais eficiente com o pente metálico microcanaliculado. O método visual leva a uma subestimação das infestações ativas e revela as passadas não ativas.

Background: Methods for the diagnosis of Pediculus humanus var. capitis are controversial and most studies are based on direct visual exam. Objective: The objective of this study was to compare the diagnosis efficacy of both direct visual exam and the use of a metal microchanelled fine-toothed comb. Methods: 946 children and teenagers 4 to 19 years of age were examined. Each individual’s hair was examined twice to determine whether there was infestation by lice or nits, through direct visual exam and the use of a metal microchanelled fine-toothed comb. Results: The visual diagnosis detected infestation in 30.7 percent of the cases, while the metal comb detected infestation in 51.5 percent. Females were the most affected. The forms of parasites detected through direct visual exam were: only lice (adults and/or nymphs) 1.4 percent, only live nits 64.8 percent and live nits and lice, 33.8 percent; with the metal comb the percentages were 6.4 percent, 23.6 percent and 70 percent, respectively. The average time to find a louse was 57 seconds with the fine-toothed comb and 116.4 seconds through the direct visual exam. Conclusions: Diagnosis with the microchanelled fine-toothed comb is twice as fast and 3.6 times more efficient than through direct visual exam.The direct visual exam detects non-active, past infestations, and underestimates active ones.