Surgical Considerations Resection or Under medical debridement of - - PowerPoint PPT Presentation

Resection or

debridement of PG ulcer

Ostomy relocation

with active disease present

Under medical

monitoring & treatment

Stoma closure Correct a parastomal

hernia

Refashion recessed

stoma

Surgical Considerations

• How are we managing PPG at Mount Sinai

Hospital? (self‐reflected practice)

• What does the literature say about the

etiology and management of Peristomal PG? (evaluation of practice)

• Can we do it better?...and How?

(best evidenced based practice)

• Brief email to ETN colleagues in Western,

Mid‐western and Central Canada

• 6 acute care hospitals

1.

Do you have a protocol for the management

• f PPG? NO

2.

Who usually manages PPG in your facility? Dermatologist & ETN wound care

2000‐2011 31 articles reviewed; 14 retained Literature review

3 (2 medical & 1 nursing)

General management

1

Surgical management

1

Medical management

3

Medical and

wound management 2

Research(LOE III)

4

Core Team ~

• Kathryn Kozell, RN, MScN,

CETN(C)

• Monica Frecea, RN, ETN,

MN(c)

• Julie Tjan Thomas, RN, MN,

ETN

• Brenda O’Connor, RN, BScN,

Research Nurse Coordinator

• Dr. Cheryl Rosen,

Dermatologist

• Dr. Geoffrey Nguyan, GI

Medicine, Researcher (Quality

• f Life)

Mission ~

Optimize the care and quality of life

• f patient’s suffering from

peristomal pyoderma gangrenosum across the continuum of care through the development & dissemination of evidence based interdisciplinary recommendations .

Patient/family centred design and validation (patient advisor) Interdisciplinary approach based recommendations (evidence

based)

Additional development team members : patient/family,

pharmacy, pain management, social work, infectious disease

Diagnosis/treatment/management/on‐going care Mild/moderate/severe presentations Development or adoption of a

peristomal skin assessment tool (DET)

Quality of life dermatology tools (validated) PPG Registry (peristomal complications) AGREE Validation Endorsement (professional associations e.g. CAET, Canadian

Dermatology Association)

Publication