Construção de protocolo de assistência perioperatória destinado às pessoas com estomia intestinal

André Lucas de Lima Dias; Wagner Felipe dos Santos Neves; Fernando Conceição de Lima; Tais dos Passos Sagica; Antonio Jorge Silva Correa Júnior; Clarissa Porfírio Mendes; Helena Megumi Sonobe; Mary Elizabeth de Santana

Authors

André Lucas de Lima Dias Universidade do Estado do Pará – Belém (PA) https://orcid.org/0000-0002-6820-6801
Wagner Felipe dos Santos Neves Universidade de São Paulo – São Paulo (SP), Brasil. https://orcid.org/0000-0001-9989-7273
Fernando Conceição de Lima Universidade do Estado do Pará – Belém (PA), Brazil. https://orcid.org/0000-0002-9418-3711
Tais dos Passos Sagica Universidade do Estado do Pará – Belém (PA), Brasil. ,https://ror.org/042r36z33 https://orcid.org/0000-0002-6871-0100
Antonio Jorge Silva Correa Júnior Universidade de São Paulo – São Paulo (SP), Brasil. ,https://ror.org/036rp1748 https://orcid.org/0000-0003-1665-1521
Clarissa Porfírio Mendes Universidade do Estado do Pará – Belém (PA), Brazil. ,https://ror.org/042r36z33 https://orcid.org/0000-0001-6488-718X
Helena Megumi Sonobe Universidade de São Paulo – São Paulo (SP), Brazil. ,https://ror.org/036rp1748 https://orcid.org/0000-0003-3722-0835
Mary Elizabeth de Santana Universidade do Estado do Pará – Belém (PA), Brazil. ,https://ror.org/042r36z33 https://orcid.org/0000-0002-3629-8932

Abstract

Objective: To develop a nursing protocol to guide perioperative care for individuals with intestinal ostomies. Method: A methodological study conducted between March and June 2022, using a quantitative approach. The study was divided into three stages: 1) an exploratory phase to determine the characteristics of the target population using a questionnaire; 2) the definition of perioperative recommendations based on Enhanced Recovery After Surgery® (ERAS); and 3) the creation of the protocol. Data analysis involved simple descriptive statistics. Results: Ten (10) patients responded preoperatively, while only six (6) responded postoperatively. Preoperative education was provided by nurses in 50% of cases. Findings showed an absence of ostomy site marking in 90% of cases, insufficient self-care in 60%, and postoperative complications in 60%, including edema, mucocutaneous separation, contact dermatitis, peristomal hernia, edge maceration, and granuloma. The proposed protocol consists of a care flowchart with four lines of follow-up within the institution and a consolidated framework with four key axes of perioperative nursing actions. Each axis includes sub-axes that detail specific guidelines to be implemented. Conclusion: The situational analysis of the target population and perioperative complications demonstrated the feasibility of developing a perioperative care protocol focused on the immediate preoperative, intraoperative, and postoperative phases.

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