الفهرس 
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Abstract
Summary
Colostomy is a stoma of the colon with the aim of diverting feces and flatus. It is the most common stoma used in children. Colostomy may be either congenital or acquired. Congenital indications are more common and include high anorectal anomalies and Hirschsprung’s disease. Acquired indications include bowel perforation, severe perineal traumas, post-trauma paralysis, and to protect distal anastomoses (such as coloanal anastomosis of pull-through procedures).
Keeping the peristomal skin intact proves to be a challenge for the patients, their caregivers, and the health care team. Peristomal skin complications affect 18%–73% of patients. Complications range from mild irritation to full thickness ulcerations leading to pain, anxiety, and may significant social isolation related to the pouching system leaks. Common postoperative complications usually occur within the first two weeks of the creation of the stoma. Peristomal skin complications can also present as late complications, months or even years after the initial surgery. Many studies affirmed that the acacia gum has prefect effect on alleviating peristomal skin problems in children with colostomy due to its anti -inflammatory properties.
The study aimed to evaluate the efficacy of Acacia Senegal on peristomal skin problems in children with colostomy.
Setting:
This study was conducted in the Pediatric Surgery Unit and Pediatric Surgery outpatient clinic at Assiut University Children Hospital.
Tools of the study
Two tools were used to fulfill this study:
Tool (1): A structured interview questionnaire: It included two parts as following:
Personal characteristics and clinical data of the child and personal characteristics child’s mother.
Tool (2): Ostomy Skin Tool Score: It is developed by (Martins et al., 2013) to help health care professionals in assessing and evaluating the condition of peristomal skin reliably and accurately.
Main results of this study revealed that:
More than half of children were female, most children were in (1-<3 years) age group and in second birth order. According to residence more than half of children came from rural. The high anorectal anomalies and Hirschsprung’s disease were the main indications for colostomy.
More than half of mothers their age ranged from (25 - < 35) years, Majority of them were educated and house wives.
There were statistical significant differences between children in the Acacia and the control groups in domains of discoloration (area and severity) with p value (<0.000) and erosion (area and severity) with p value (<0.000) in three months after colostomy.
It was found that there was positive co- relation between OST total score and child’s birth order and mothers, (age and number of children).
It noticed that there were statistical significant differences between OST total score and mother’s education and occupation in the first month after colostomy and statistical significant differences were found between OST total and mother’s education in the second and third month after colostomy.
Conclusion:
Children with colostomy who exposed to acacia Senegal gum peristomal skin care had lower peristomal skin problems, such as discoloration, erosion and tissue overgrowth in compare to those with the routine care
Recommendations:
Based on the results of this study, the following recommendations are suggested:
Other peristomal skin care modalities should be encouraged to use by the staff especially natural products as acacia which known since decades to decrease skin problems and with support of evidence-based practice to these materials.
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