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Timing of neonatal stoma closure: a survey of health professional perspectives and current practice
  1. Jonathan Ducey1,
  2. Ann M Kennedy2,
  3. Louise Linsell2,
  4. Kerry Woolfall3,
  5. Nigel J Hall4,
  6. Chris Gale5,
  7. Cheryl Battersby5,
  8. Gareth Penman6,
  9. Marian Knight2,
  10. Nick Lansdale1,7
  1. 1 Department of Paediatric and Neonatal Surgery, Royal Manchester Children's Hospital, Manchester, UK
  2. 2 National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
  3. 3 Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
  4. 4 University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK
  5. 5 Faculty of Medicine, School of Public Health, Imperial College London, London, UK
  6. 6 Newborn Intensive Care Unit, St Mary’s Hospital, Manchester, UK
  7. 7 Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
  1. Correspondence to Nick Lansdale, Department of Paediatric and Neonatal Surgery, Royal Manchester Children's Hospital, Manchester M13 9WL, UK; Nick.Lansdale2{at}mft.nhs.uk

Abstract

Optimal timing for neonatal stoma closure remains unclear. In this study, we aimed to establish current practice and illustrate multidisciplinary perspectives on timing of stoma closure using an online survey sent to all 27 UK neonatal surgical units, as part of a research programme to determine the feasibility of a clinical trial comparing ‘early’ and ‘late’ stoma closure. 166 responses from all 27 units demonstrated concordance of opinion in target time for closure (6 weeks most commonly stated across scenarios), although there was a high variability in practice. A sizeable proportion (41%) of respondents use weight, rather than time, to determine when to close a neonatal stoma. Thematic analysis of free text responses identified nine key themes influencing decision-making; most related to nutrition, growth and stoma complications. These data provide an overview of current practice that is critical to informing an acceptable trial design.

  • neonatology
  • growth
  • gastroenterology
  • qualitative research
https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/archdischild-2021-322040

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    Footnotes

    • Twitter @DrCGale, @DrCBattersby, @Marianfknight, @ToSCiN2

    • Presented at The British Association of Paediatric Surgeons Annual Congress 2021

    • Funding This study/project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme (project reference NIHR 128617). Further details, including the study protocol, can be found on https://wwwnpeuoxacuk/toscin. MK is an NIHR senior investigator.

    • Disclaimer The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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