The use of a convex light appliance and mouldable rings for patients with an ostomy and effluent leakage in the early postoperative period

Abstract

Patients with digestive ostomies frequently experience effluent leakage in the early postoperative period, leading to complications and reduced quality of life. The convex appliance and adaptable rings in ostomy (CONAN) study investigated a new combined treatment strategy for reducing leakage and improving patient satisfaction. This prospective, multicenter study involved 244 patients with digestive ostomies and early effluent leakage across 54 stoma units in Spain. Patients were treated with the CONAN strategy, using a light convex ostomy appliance (Easiflex Confort Convex Light) and a flexible ring (Brava moldable). Stoma care nurses collected data on leak episodes per day and patient satisfaction (0–10 scale) at baseline and 2–3 weeks post-discharge. Multivariate analysis identified patient characteristics associated with greater treatment benefit. Patients experienced a significant reduction in mean leak episodes per day (3.4 ± 5.2 to 1.3 ± 2.3, p<.0001). Mean patient satisfaction significantly increased post-treatment (5.1 ± 2 to 7.2 ± 1.7, p<.0001). Multivariate analysis revealed the following factors were associated with high patient satisfaction (≥ 8 over 10): shorter hospital admission, programmed surgery (vs. emergency), closed ostomy appliance (vs. open) and multi-piece appliance systems. The CONAN strategy, combining a light convex ostomy appliance and flexible rings, effectively reduces leakage and improves satisfaction in patients with digestive ostomies and early effluent leakage. Patients with longer hospital stays, emergency ostomy surgery, open ostomy systems and single-piece appliances may benefit most from early intervention with this strategy.