{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T16:30:04Z","timestamp":1759336204888},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,3]]},"abstract":"\n PURPOSE:<\/jats:title>\n The primary objective of the study was to evaluate the safety and efficacy of a stool management kit (SMK) for containment of fecal incontinence in hospitalized bedridden patients.<\/jats:p>\n <\/jats:sec>\n \n DESIGN:<\/jats:title>\n A single-group quasi-experimental study.<\/jats:p>\n <\/jats:sec>\n \n SUBJECTS AND SETTING:<\/jats:title>\n Twenty bedridden adults who had at least 1 episode of fecal incontinence in the prior 24 hours participated in the study. The study setting was the neurological unit of the All India Institute of Medical Sciences in New Delhi, India.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n The study was carried out in 2 phases. The device was placed in situ for up to 24 hours in 10 patients during phase I of the study and up to 120 hours in an additional 10 patients during phase II. Participants were assessed for anorectal injury and peripheral device leakage on a 4- to 6-hourly basis. Sigmoidoscopy was performed to evaluate for any mucosal trauma or alteration of anorectal pathology after retrieval of the device.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n The device was successfully placed in all patients following the first attempt to place the device; 80% of patients retained the device until planned removal. The SMK diverted fecal matter without anal leakage in 174 (93.5%) out of 186 assessment points in a group of 20 patients. The devices remained in situ for 21 \u00b1 0.2 and 84.5 \u00b1 38.9 hours during phase I and phase II, respectively. None experienced anorectal bleeding, sphincter injury, or mucosal ulceration with device usage. Post\u2013device sigmoidoscopy revealed erythema at the site of diverter placement in 2 participants.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION:<\/jats:title>\n Study findings suggest that the SMK successfully diverted liquid to semiformed fecal exudate without peripheral device leakage in 93.5% of bedridden patients. No serious adverse events occurred. Additional research is needed to compare its effectiveness with that of currently available intrarectal balloon devices.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/won.0000000000000408","type":"journal-article","created":{"date-parts":[[2018,3,8]],"date-time":"2018-03-08T11:54:16Z","timestamp":1520510056000},"page":"156-162","source":"Crossref","is-referenced-by-count":6,"title":["Clinical Evaluation of a Novel Intrarectal Device for Management of Fecal Incontinence in Bedridden Patients"],"prefix":"10.1097","volume":"45","author":[{"given":"Sandeep","family":"Singh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Balram","family":"Bhargava","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Padma","family":"Vasantha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohit","family":"Bhatia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanish","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujoy","family":"Pal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peush","family":"Sahni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Govind K.","family":"Makharia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"issue":"5","key":"R1-20230826","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1097\/WON.0000000000000265","article-title":"Prevalence of fecal incontinence in the acute care setting","volume":"43","author":"Stokes","year":"2016","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"3","key":"R2-20230826","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1097\/WON.0000000000000225","article-title":"Pressure ulcer risk in the incontinent patient: analysis of incontinence and hospital-acquired pressure ulcers from the International Pressure Ulcer Prevalence\u2122 Survey","volume":"43","author":"Lachenbruch","year":"2016","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"3","key":"R3-20230826","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1002\/nur.21593","article-title":"A systematic review and meta-analysis of incontinence-associated dermatitis, incontinence, and moisture as risk factors for pressure ulcer development","volume":"37","author":"Beeckman","year":"2014","journal-title":"Res Nurs Health"},{"issue":"3","key":"R4-20230826","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1097\/01.WON.0000270820.91694.1f","article-title":"Prevalence of incontinence and associated skin injury in the acute care inpatient","volume":"34","author":"Junkin","year":"2007","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"1","key":"R5-20230826","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1097\/01.WON.0000308626.53335.37","article-title":"Emerging options for the management of fecal incontinence in hospitalized patients","volume":"35","author":"Wishin","year":"2008","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"1","key":"R6-20230826","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1097\/WON.0b013e31823fe246","article-title":"Incontinence-associated dermatitis: a comprehensive review and update","volume":"39","author":"Gray","year":"2012","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"12","key":"R7-20230826","first-page":"56","article-title":"Fecal incontinence in acutely and critically ill patients: options in management","volume":"52","author":"Beitz","year":"2006","journal-title":"Ostomy Wound Manage"},{"issue":"7","key":"R8-20230826","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1007\/s10350-006-0882-x","article-title":"A nonsurgical means of fecal diversion: the Zassi Bowel Management System","volume":"50","author":"Keshava","year":"2007","journal-title":"Dis Colon Rectum"},{"issue":"6","key":"R9-20230826","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1097\/WON.0b013e31826a4b9c","article-title":"Methods of bowel management in critical care: a randomized controlled trial","volume":"39","author":"Pittman","year":"2012","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"5","key":"R10-20230826","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1097\/WON.0000000000000055","article-title":"Stool management systems for preventing environmental spread of Clostridium difficile: a comparative trial","volume":"41","author":"Gray","year":"2014","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"4","key":"R11-20230826","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1097\/NNA.0b013e3182895a3c","article-title":"The value of reducing hospital-acquired pressure ulcer prevalence: an illustrative analysis","volume":"43","author":"Spetz","year":"2013","journal-title":"J Nurs Adm"},{"issue":"9","key":"R12-20230826","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1111\/j.1532-5415.2012.04106.x","article-title":"Hospital-acquired pressure ulcers: results from the national Medicare Patient Safety Monitoring System study","volume":"60","author":"Lyder","year":"2012","journal-title":"J Am Geriatr Soc"},{"issue":"3","key":"R13-20230826","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1086\/502542","article-title":"Effect of pressure ulcers on length of hospital stay","volume":"26","author":"Graves","year":"2005","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"6","key":"R14-20230826","first-page":"257","article-title":"Hospital-acquired pressure ulcers at academic medical centers in the United States, 2008-2012: tracking changes since the CMS nonpayment policy","volume":"41","author":"Padula","year":"2015","journal-title":"Jt Comm J Qual Patient Saf"},{"issue":"6","key":"R15-20230826","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1592\/phco.31.6.546","article-title":"Economic impact of Clostridium difficile infection in a multihospital cohort of academic health centers","volume":"31","author":"Pakyz","year":"2011","journal-title":"Pharmacotherapy"},{"issue":"11","key":"R16-20230826","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1017\/S0195941700026072","article-title":"The emerging infectious challenge of Clostridium difficile-associated disease in Massachusetts hospitals: clinical and economic consequences","volume":"28","author":"O'Brien","year":"2007","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"11","key":"R17-20230826","doi-asserted-by":"crossref","first-page":"1733","DOI":"10.1111\/j.1440-1746.2012.07242.x","article-title":"Impact of hospital-acquired Clostridium difficile","volume":"27","author":"Lipp","year":"2012","journal-title":"J Gastroenterol Hepatol"},{"issue":"11","key":"R18-20230826","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1016\/j.ajic.2015.06.004","article-title":"Impact of Clostridium difficile-associated diarrhea on acute care length of stay, hospital costs, and readmission: a multicenter retrospective study of inpatients, 2009-2011","volume":"43","author":"Magee","year":"2015","journal-title":"Am J Infect Control"},{"issue":"1","key":"R19-20230826","doi-asserted-by":"crossref","first-page":"ofv186","DOI":"10.1093\/ofid\/ofv186","article-title":"Prevalence and clinical outcomes of Clostridium difficile infection in the intensive care unit: a systematic review and meta-analysis","volume":"3","author":"Karanika","year":"2015","journal-title":"Open Forum Infect Dis"},{"issue":"7","key":"R20-20230826","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1086\/518518","article-title":"Underresourced hospital infection control and prevention programs: penny wise, pound foolish?","volume":"28","author":"Anderson","year":"2007","journal-title":"Infect Control Hosp Epidemiol"},{"key":"R21-20230826","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1478-7547-8-8","article-title":"Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of intensive care units in Italy","volume":"8","author":"Tarricone","year":"2010","journal-title":"Cost Eff Resour Alloc"},{"issue":"2","key":"R22-20230826","doi-asserted-by":"crossref","first-page":"R100","DOI":"10.1186\/cc10114","article-title":"Acquired bloodstream infection in the intensive care unit: incidence and attributable mortality","volume":"15","author":"Prowle","year":"2011","journal-title":"Crit Care"},{"issue":"1","key":"R23-20230826","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1086\/501964","article-title":"The direct costs of nosocomial catheter-associated urinary tract infection in the era of managed care","volume":"23","author":"Tambyah","year":"2002","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"5","key":"R24-20230826","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1586\/erp.09.53","article-title":"Economic burden of healthcare-associated infections: an American perspective","volume":"9","author":"Stone","year":"2009","journal-title":"Expert Rev Pharmacoecon Outcomes Res"},{"issue":"10","key":"R25-20230826","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1001\/jamasurg.2013.2246","article-title":"Financial impact of surgical site infections on hospitals: the hospital management perspective","volume":"148","author":"Shepard","year":"2013","journal-title":"JAMA Surg"},{"issue":"1","key":"R26-20230826","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.jhin.2013.09.012","article-title":"Clinical and economic burden of surgical site infection (SSI) and predicted financial consequences of elimination of SSI from an English hospital","volume":"86","author":"Jenks","year":"2014","journal-title":"J Hosp Infect"},{"issue":"6","key":"R27-20230826","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1001\/jamasurg.2013.4663","article-title":"Costs associated with surgical site infections in Veterans Affairs hospitals","volume":"149","author":"Schweizer","year":"2014","journal-title":"JAMA Surg"},{"issue":"4","key":"R28-20230826","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1038\/ajg.2015.48","article-title":"The economic impact of Clostridium difficile infection: a systematic review","volume":"110","author":"Nanwa","year":"2015","journal-title":"Am J Gastroenterol"},{"issue":"4","key":"R30-20230826","doi-asserted-by":"crossref","first-page":"384","DOI":"10.4037\/ajcc2007.16.4.384","article-title":"Clinical evaluation of a flexible fecal incontinence management system","volume":"16","author":"Padmanabhan","year":"2007","journal-title":"Am J Crit Care"},{"issue":"2","key":"R31-20230826","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1097\/01.WON.0000264830.26355.64","article-title":"The effect of a pressure ulcer prevention program and the bowel management system in reducing pressure ulcer prevalence in an ICU setting","volume":"34","author":"Benoit","year":"2007","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"6","key":"R32-20230826","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1097\/01.WON.0000300279.82262.07","article-title":"Clinical utility and economic impact of introducing a bowel management system","volume":"34","author":"Echols","year":"2007","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"12","key":"R33-20230826","first-page":"25","article-title":"A budget impact analysis comparing use of a modern fecal management system to traditional fecal management methods in two Canadian hospitals","volume":"58","author":"Langill","year":"2012","journal-title":"Ostomy Wound Manage"},{"issue":"3","key":"R34-20230826","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.4037\/ajcc2009521","article-title":"Fecal containment in bedridden patients: economic impact of 2 commercial bowel catheter systems","volume":"18","author":"Kowal-Vem","year":"2009","journal-title":"Am J Crit Care"},{"issue":"9","key":"R35-20230826","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1007\/s10350-008-9227-2","article-title":"Significant rectal bleeding as a complication of a fecal collecting device: report of a case","volume":"51","author":"Page","year":"2008","journal-title":"Dis Colon Rectum"},{"issue":"6","key":"R36-20230826","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1016\/j.burns.2007.11.009","article-title":"A non-surgical device for faecal diversion in the management of perineal burns","volume":"34","author":"Bordes","year":"2008","journal-title":"Burns"},{"issue":"3","key":"R37-20230826","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1007\/DCR.0b013e3181c38351","article-title":"Rectal trauma and associated hemorrhage with the use of the ConvaTec Flexi-Seal fecal management system: report of 3 cases","volume":"53","author":"Sparks","year":"2010","journal-title":"Dis Colon Rectum"},{"issue":"3","key":"R38-20230826","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.aucc.2012.02.001","article-title":"A case of pressure ulceration and associated haemorrhage in a patient using a faecal management system","volume":"25","author":"Reynolds","year":"2012","journal-title":"Aust Crit Care"},{"issue":"1","key":"R39-20230826","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1177\/1756283X13501947","article-title":"Complete circumferential rectal ulceration and haemorrhage secondary to the use of a faecal management system","volume":"7","author":"Shaker","year":"2014","journal-title":"Ther Adv Gastroenterol"},{"issue":"3","key":"R40-20230826","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1159\/000155147","article-title":"Indwelling bowel management system as a cause of life-threatening rectal bleeding","volume":"2","author":"Bright","year":"2008","journal-title":"Case Rep Gastroenterol"},{"issue":"12","key":"R41-20230826","first-page":"37","article-title":"A retrospective review of outcomes using a fecal management system in acute care patients","volume":"60","author":"Whiteley","year":"2014","journal-title":"Ostomy Wound Manage"},{"issue":"3","key":"R42-20230826","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1097\/WON.0000000000000128","article-title":"Randomized controlled study of the effects of 2 fecal management systems on incidence of anal erosion","volume":"42","author":"Sammon","year":"2015","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"6","key":"R44-20230826","first-page":"25","article-title":"Risk factors associated with having a pressure ulcer: a secondary data analysis","volume":"7","author":"Maklebust","year":"1994","journal-title":"Adv Wound Care"},{"issue":"3","key":"R45-20230826","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.idc.2009.04.011","article-title":"Clostridium difficile infection in the intensive care unit","volume":"23","author":"Riddle","year":"2009","journal-title":"Infect Dis Clin North Am"},{"issue":"8","key":"R46-20230826","doi-asserted-by":"crossref","first-page":"e104702","DOI":"10.1371\/journal.pone.0104702","article-title":"Characteristics of hospital-acquired and community-onset blood stream infections, South-East Austria","volume":"9","author":"Hoenigl","year":"2014","journal-title":"PLoS One"},{"issue":"14","key":"R47-20230826","doi-asserted-by":"crossref","first-page":"1868","DOI":"10.1001\/jama.290.14.1868","article-title":"Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization","volume":"290","author":"Zhan","year":"2003","journal-title":"JAMA"},{"issue":"3","key":"R48-20230826","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1067\/mic.2002.121099","article-title":"A systematic audit of economic evidence linking nosocomial infections and infection control interventions: 1990-2000","volume":"30","author":"Stone","year":"2002","journal-title":"Am J Infect Control"},{"issue":"10","key":"R49-20230826","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1086\/425309","article-title":"Use of maximal sterile barriers during central venous catheter insertion: clinical and economic outcomes","volume":"39","author":"Hu","year":"2004","journal-title":"Clin Infect Dis"},{"issue":"9","key":"R50-20230826","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1002\/jhm.2079","article-title":"Estimating hospital costs of catheter-associated urinary tract infection","volume":"8","author":"Kennedy","year":"2013","journal-title":"J Hosp Med"},{"issue":"6","key":"R51-20230826","doi-asserted-by":"crossref","first-page":"537","DOI":"10.4037\/ajcc2013499","article-title":"Massive gastrointestinal hemorrhage as a complication of the Flexi-Seal fecal management system","volume":"22","author":"Mulhall","year":"2013","journal-title":"Am J Crit Care"},{"key":"R52-20230826","article-title":"Rectal bleeding post the use of the Flexi-Seal faecal management system [published online ahead of print","author":"Daniel","journal-title":"ANZ J Surg"},{"issue":"4","key":"R53-20230826","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.iccn.2013.12.003","article-title":"Rectourethral fistula secondary to a bowel management system","volume":"30","author":"A'Court","year":"2014","journal-title":"Intensive Crit Care Nurs"},{"issue":"4","key":"R54-20230826","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.jcol.2015.06.005","article-title":"A case of rectal stricture associated with the use of a fecal management system","volume":"35","author":"Chatterjee","year":"2015","journal-title":"J Coloproctol"}],"container-title":["Journal of Wound, Ostomy & Continence Nursing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00152192-201803000-00009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,26]],"date-time":"2023-08-26T07:21:24Z","timestamp":1693034484000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00152192-201803000-00009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3]]},"references-count":52,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1097\/won.0000000000000408","relation":{},"ISSN":["1071-5754"],"issn-type":[{"value":"1071-5754","type":"print"}],"subject":[],"published":{"date-parts":[[2018,3]]}}}