Nursing care related to the prevention of prolapse in intestinal ostomies: an integrative literature review




Ostomy; Postoperative Complications; Prolapse; Nursing Care; Enterostomal therapy.


Objective: To identify the main nursing care related to the prevention of prolapse in intestinal ostomies. Methodology: This is an integrative review, using the databases of Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), Scientific Electronic Library Online (SciELO), Base de Dados de Enfermagem (BDENF), Medical Literature Analysis and Retrieval System On-line (PubMed/MedLine) and Cumulative Index to Nursing and Allied Health Literature (CINAHL), in Portuguese, English and Spanish, published between 2011 and 2020. After searching the scientific literature, twenty-two studies were selected for analysis on the care related to the prevention of prolapse. Results: The demarcation of the stoma, preoperative education, educational telephone follow-up of post-discharge support carried out by the stomatherapist were appointed as care and/or strategies for preventing prolapse. Conclusion: Previous surgical demarcation of the stoma associated with preoperative education and education and/or intervention programs aimed at postoperative ostomy management can be considered important care technologies capable of preventing prolapse in intestinal ostomies. However, the realization of demarcation still lacks more robust scientific evidence, considering that its practice is still not carried out, on a large scale, in the international scope.

Author Biographies

Alberto Matos dos Santos, Universidade Federal de Sergipe

Mestrando do Programa de Pós-Graduação da Universidade Federal de Sergipe. Enfermeiro da Secretaria Municipal de Saúde do Natal - RN.

Eliana Ofelia Llapa Rodriguez, Universidade Federal de Sergipe

Teacher of the Nursing course at the Federal University of Sergipe

Ana Cristina Freire Abud, Universidade Federal de Sergipe

Teacher of the Nursing Course at the Federal University of Sergipe


Aguiar, J. C., Pereira, A. P. dos S., & Pinto, M. H. (2018). Reconstrução de trânsito intestinal: fatores que influenciam a realização. Revista Eletrônica De Enfermagem, 20(32), 1-10.

Almeida, A. O. D., Dantas, S. R. P. E., Paula, M. A. B. D., Silva, J. L. G., Franck, E. M., & Oliveira-Kumakura, A. R. D. S. (2021). Construção, validação e aplicação de cenários de simulação clínica para avaliação de especialistas em estomaterapia. Revista Brasileira de Enfermagem, 74(1).

Altschuler, A., Liljestrand, P., Grant, M., Hornbrook, M. C., Krouse, R. S., & McMullen, C. K. (2018). Caregiving and mutuality among long-term colorectal cancer survivors with ostomies: qualitative study. Supportive Care in Cancer, 26(2), 529-537.

Ambe, P. C., Kurz, N. R., Nitschke, C., Odeh, S. F., Möslein, G., & Zirngibl, H. (2018). Intestinal ostomy: classification, indications, ostomy care and complication management. Deutsches Ärzteblatt International, 115(11), 182.

Arolfo, S., Borgiotto, C., Bosio, G., Mistrangelo, M., Allaix, M. E., & Morino, M. (2018). Preoperative stoma site marking: a simple practice to reduce stoma-related complications. Techniques in coloproctology, 22(9), 683-687.

Braumann, C., Müller, V., Knies, M., Aufmesser, B., Schwenk, W., & Koplin, G. (2016). Quality of life and need for care in patients with an ostomy: a survey of 2647 patients of the Berlin OStomy-Study (BOSS). Langenbeck's archives of surgery, 401(8), 1191-1201.

Bulkley, J. E., McMullen, C. K., Grant, M., Wendel, C., Hornbrook, M. C., & Krouse, R. S. (2018). Ongoing ostomy self-care challenges of long-term rectal cancer survivors. Supportive care in cancer, 26(11), 3933-3939.

Byfield, D. (2020). The Lived Experiences of Persons With Ostomies Attending a Support Group: A Qualitative Study. Journal of Wound, Ostomy and Continence Nursing, 47(5), 489-495.

Carlsson, E., Fingren, J., Hallén, A. M., Petersén, C., & Lindholm, E. (2016). The prevalence of ostomy-related complications 1 year after ostomy surgery: A prospective, descriptive, clinical study. Ostomy/wound management, 62(10), 34-48.

Cengiz, B., & Bahar, Z. (2017). Perceived barriers and home care needs when adapting to a fecal ostomy. Journal of Wound, Ostomy and Continence Nursing, 44(1), 63-68.

Coca, C., Fernández de Larrinoa, I., Serrano, R., & García-Llana, H. (2015). The impact of specialty practice nursing care on health-related quality of life in persons with ostomies. Journal of Wound, Ostomy and Continence Nursing, 42(3), 257-263.

Coelho, A. M. S., de Oliveira, C. G., Bezerra, S. T. F., Almeida, A. N. S., Cabral, R. L., & Coelho, M. M. F. (2015). Self care of patients with colostomy, peristomal skin and collecting bag. J Nurs UFPE on line, 9, 9528-34.

Corvese, F., Giordano, V., Alvaro, R., Vellone, E., & Villa, G. (2020). Sociodemographic characteristics and self-care management knowledge of patients with an ostomy. British Journal of Nursing, 29(22), S20-S26.

Costa, J. M. da, Ramos, R. de S., Santos, M. M. dos, Silva, D. F. da, Gomes, T. da S., & Batista, R. Q. (2017). Complicações do estoma intestinal em pacientes em pós- operatório de ressecção de tumores de reto. Revista Enfermagem Atual In Derme, 34-42.

De Araújo, A. C., Menezes A. M., Ramirez A. C. F. O., Kotovicz B. B. de M., Ueda C. C., Fernandes Ítalo R. de Q., Lopes J. R., Rodrigues L. P., Dourado M. V. F., & Corrêa W. P. (2021). Principais complicações da reconstrução do trato intestinal após colostomia à Hartmann. Revista Eletrônica Acervo Saúde, 13(3), e6594.

De Melo, G. D. N., De Meireles, D. S., de Araújo, C. S., & dos Santos, M. S. (2021). Autoimagem de mulheres portadoras de colostomia e os cuidados dermatológicos periestoma: revisão integrativa. Brazilian Journal of Health Review, 4(1), 991-1001.

Duluklu, B., & Çelik, S. Ş. (2019). Effects of lavender essential oil for colorectal cancer patients with permanent colostomy on elimination of odor, quality of life, and ostomy adjustment: A randomized controlled trial. European Journal of Oncology Nursing, 42, 90-96.

Estrada, D. M. L., Benghi, L. M., & Kotze, P. G. (2021). Practical insights into stomas in inflammatory bowel disease: what every healthcare provider needs to know. Current Opinion in Gastroenterology, 37(4), 320-327.

Giordano, V., Nicolotti, M., Corvese, F., Vellone, E., Alvaro, R., & Villa, G. (2020). Describing self‐care and its associated variables in ostomy patients. Journal of Advanced Nursing, 76(11), 2982-2992.

Grahn, S. W., Lowry, A. C., Osborne, M. C., Melton, G. B., Gaertner, W. B., Vogler, S. A., ... & Kwaan, M. R. (2019). System-wide improvement for transitions after ileostomy surgery: can intensive monitoring of protocol compliance decrease readmissions? A randomized trial. Diseases of the Colon & Rectum, 62(3), 363-370.

Hamidi, Y., Moeini, M., & Yousefi, H. (2018). The effect of an interactive follow-up program on ostomy adjustment of inpatients after their discharge from surgical wards of the hospitals affiliated to Isfahan University of Medical Sciences. International journal of colorectal disease, 33(9), 1295-1297.

Harris, M. S., Kelly, K., & Parise, C. (2020). Does preoperative ostomy education decrease anxiety in the new ostomy patient? A quantitative comparison cohort study. Journal of Wound Ostomy & Continence Nursing, 47(2), 137-139.

Heerschap, C., & Butt, B. (2021). Algorithmic approaches to ostomy management: An integrative review. Nursing Open, 8(6), 2912-2921.

Hendren, S., Hammond, K., Glasgow, S. C., Perry, W. B., Buie, W. D., Steele, S. R., & Rafferty, J. (2015). Clinical practice guidelines for ostomy surgery. Diseases of the Colon & Rectum, 58(4), 375-387.

Hsu, M. Y., Lin, J. P., Hsu, H. H., Lai, H. L., & Wu, Y. L. (2020). Preoperative stoma site marking decreases stoma and peristomal complications: a meta-analysis. Journal of Wound Ostomy & Continence Nursing, 47(3), 249-256.

Ilyas, M. I. M., Haggstrom, D. A., Maggard-Gibbons, M. A., Wendel, C. S., Rawl, S., Schmidt, C. M., ... & Krouse, R. S. (2018). Patients with temporary ostomies: veterans administration hospitals multi-institutional retrospective study. Journal of Wound Ostomy & Continence Nursing, 45(6), 510-515.

Karabulut, H. K., Dinç, L., & Karadag, A. (2014). Effects of planned group interactions on the social adaptation of individuals with an intestinal stoma: a quantitative study. Journal of clinical nursing, 23(19-20), 2800-2813.

Kerr, N. (2015). Ostomate-for-a-day: A novel pedagogy for teaching ostomy care to baccalaureate nursing students. Journal of Nursing Education, 54(8), 445-449.

Kim, Y. M., Jang, H. J., & Lee, Y. J. (2021). The effectiveness of preoperative stoma site marking on patient outcomes: A systematic review and meta‐analysis. Journal of Advanced Nursing, 77(11): 4332-4346.

Krebsgesellschaft, D., & Deutsche Krebshilfe, A. W. M. F. (2019). S3-Leitlinie Kolorektales Karzinom, Langversion 1.0, AWMF Registrierungsnummer: 021-007OL. Im Internet: http://leitlinienprogramm-onkologie. de/leitlinien, 7.

Krouse, R. S., Grant, M., McCorkle, R., Wendel, C. S., Cobb, M. D., Tallman, N. J., ... & Hornbrook, M. C. (2016). A chronic care ostomy self‐management program for cancer survivors. Psycho‐oncology, 25(5), 574-581.

McGee, M. F. (2016). Stomas. Jama, 315(18), 2032-2032.

Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). The establishment of evidence‐based practice competencies for practicing registered nurses and advanced practice nurses in real‐world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence‐Based Nursing, 11(1), 5-15.

Millard, R., Cooper, D., & Boyle, M. J. (2020). Improving Self-Care Outcomes in Ostomy Patients via Education and Standardized Discharge Criteria. Home healthcare now, 38(1), 16-23.

Moura, L. K. B., Sousa, A. F. L., Nascimento, G. C., & Queiroz AAFLN, S. D. (2015). Biosafety measures in dental procedures: an integrative review. J Nurs UFPE on line [Internet], 9(10), 1537-44.

Murken, D. R., & Bleier, J. I. (2019). Ostomy-related complications. Clinics in colon and rectal surgery, 32(03), 176-182.

Nafees, B., Størling, Z. M., Hindsberger, C., & Lloyd, A. (2018). The ostomy leak impact tool: development and validation of a new patient-reported tool to measure the burden of leakage in ostomy device users. Health and quality of life outcomes, 16(1), 1-12.

Nascimento, M. V. F., da Vera, S. O., Silva, M. C. R., de Morais, F. F., Andrade, E. M. L. R., & Bastos, S. N. M. A. N. (2018). Perfil sociodemográfico e clínico de pacientes em pós-operatório de confecção de estomas intestinais de eliminação. Cienc. enferm, 24(15), 1-13.

O'Flynn, S. K. (2018). Care of the stoma: complications and treatments. British journal of community nursing, 23(8), 382-387.

Ouzzani, M., Hammady, H., Fedorowicz, Z., & Elmagarmid, A. (2016). Rayyan—a web and mobile app for systematic reviews. Systematic reviews, 5(1), 1-10.

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., ... & Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj, 372.

Pereira, A. P. D. S., Cesarino, C. B., Martins, M. R. I., Pinto, M. H., & Netinho, J. G. (2012). Associations among socio-demographic and clinical factors and the quality of life of ostomized patients. Revista latino-americana de enfermagem, 20(1), 93-100.

Pouresmail, Z., Nabavi, F. H., Abdollahi, A., Shakeri, M. T., & Saki, A. (2019). Effect of Using a Simulation Device for Ostomy Self-care Teaching in Iran: A Pilot, Randomized Clinical Trial. Wound management & prevention, 65(6), 30-39.

Ripollés-Melchor, J., Varela, M. L. D. F., Camargo, S. C., Fernández, P. J., Barrio, Á. C. D., Martínez-Hurtado, E., ... & Calvo-Vecino, J. M. (2018). Enhanced recovery after surgery protocol versus conventional perioperative care in colorectal surgery. A single center cohort study. Revista brasileira de anestesiologia, 689(4), 358-368.

Sarabi, N., Navipour, H., & Mohammadi, E. (2017). Relative tranquility in ostomy patients’ social life: A qualitative content analysis. World journal of surgery, 41(8), 2136-2142.

Seo, H. W. (2019). Effects of the frequency of ostomy management reinforcement education on self‐care knowledge, self‐efficacy, and ability of stoma appliance change among Korean hospitalised ostomates. International wound journal, 16, 21-28.

Silva, K. A. da ., Azevedo, P. F. ., Olimpio, R. de J. J. ., Oliveira, S. T. S. de ., & Figueiredo, S. N. . (2020). Colostomia: a construção da autonomia para o autocuidado. Research, Society and Development, 9(11), e54391110377.

Sobrado Junior, C. W., Guzela, V. R., Sobrado, L. F., Nahas, S. C., & Cecconello, I. (2020). Local treatment of colostomy prolapse with the MESH STRIP technique: A novel and highly efficient day hospital technique. Clinics, 75.

Suh, S. R., & Lee, M. K. (2017, July). Effects of Nurse-Led Telephone-Based Supportive Interventions for Patients With Cancer: A Meta-Analysis. Oncology nursing fórum, 44(4):E168-E184.

Thorpe, G., McArthur, M., & Richardson, B. (2014). Healthcare experiences of patients following faecal output stoma-forming surgery: A qualitative exploration. International journal of nursing studies, 51(3), 379-389.

Ursi, E. S., & Galvão, C. M. (2006). Perioperative prevention of skin injury: an integrative literature review. Revista latino-americana de enfermagem, 14(1), 124-131.

Warrens, M. J. (2021). Kappa coefficients for dichotomous-nominal classifications. Advances in Data Analysis and Classification, 15(1), 193-208.

Wasserman, M. A., & McGee, M. F. (2017). Preoperative considerations for the ostomate. Clinics in colon and rectal surgery, 30(03), 157-161.

Wen, S. L., Li, J., Wang, A. N., Lv, M. M., Li, H. Y., Lu, Y. F., & Zhang, J. P. (2019). Effects of transtheoretical model‐based intervention on the self‐management of patients with an ostomy: A randomised controlled trial. Journal of clinical nursing, 28(9-10), 1936-1951.

Wennström, B., Johansson, A., Kalabic, S., E-son Loft, A. L., Skullman, S., & Bergh, I. (2020). Patient experience of health and care when undergoing colorectal surgery within the ERAS program. Perioperative Medicine, 9, 1-12.

Windrum, P., García-Goñi, M., & Coad, H. (2016). The impact of patient-centered versus didactic education programs in chronic patients by severity: the case of type 2 diabetes mellitus. Value in Health, 19(4), 353-362.

Wound, Ostomy and Continence Nurses Society. (2018). WOCN Society Clinical Guideline. Journal of Wound, Ostomy and Continence Nursing, 45(1), 50-58.

Xia, L. (2020). The effects of continuous care model of information-based hospital-family integration on colostomy patients: a randomized controlled trial. Journal of Cancer Education, 35(2), 301-311.

Zelga, P., Kluska, P., Zelga, M., Piasecka-Zelga, J., & Dziki, A. (2021). Patient-related factors associated with stoma and peristomal complications following fecal ostomy surgery: a scoping review. Journal of Wound, Ostomy and Continence Nursing, 48(5), 415-430.

Zhang, J. E., Wong, F. K. Y., You, L. M., Zheng, M. C., Li, Q., Zhang, B. Y., ... & Liu, J. L. (2013). Effects of enterostomal nurse telephone follow-up on postoperative adjustment of discharged colostomy patients. Cancer Nursing, 36(6), 419-428.

Zhang, Y., Xian, H., Yang, Y., Zhang, X., & Wang, X. (2019). Relationship between psychosocial adaptation and health‐related quality of life of patients with stoma: A descriptive, cross‐sectional study. Journal of clinical nursing, 28(15-16), 2880-2888.



How to Cite

SANTOS, A. M. dos .; VASCONCELOS, D. A. de .; SANTOS, G. de O. .; NASCIMENTO, J. C. .; SILVA, T. B. da .; RODRIGUEZ, E. O. L. .; ABUD, A. C. F. . Nursing care related to the prevention of prolapse in intestinal ostomies: an integrative literature review. Research, Society and Development, [S. l.], v. 11, n. 2, p. e11211225496, 2022. DOI: 10.33448/rsd-v11i2.25496. Disponível em: Acesso em: 17 jun. 2024.



Health Sciences