Chronic wound infection: bacterial colonization in the dermal pericolostomic region

Background. Little is known about the bacteriology of the pericolostomic skin region. Identifying these bacteria is important to reduce the morbidity resulting from this procedure both to control local infection and to reduce the risk of infection in other surgical sites.

The scope of this study was to determine the prevalence and type of peristomal skin bacteria in colostomy patients.

Thirty-four patients with a temporary colostomy were included in the study. Their mean age was 51.6 years. All patients had been colostomized for more than 7 weeks.

Tissue samples were obtained from the peristomal skin and were cultured. Escherichia coli was present in the peristomal skin of 81.2% of patients with malignant colorectal disease and in all cases of benign colorectal disease. The proportion of patients with Bacteroides fragilis (P = 0.021) and Klebsiella spp (P = 0.003) was higher. The incidence of Peptococcus spp (P = 0.068) was lower in patients who had their colostomy for a longer period. The cultures in the 34 patients demonstrated that the most common bacteria present were: Escherichia coli (31/34), Bacteroides spp (13/34), Peptococcus spp (13/34), Klebsiella spp (11/34), and Enterobacter spp (06/34).

The results of this study show that the dermal layer of the abdominal wall in the pericolostomic region is colonized by enteric bacteria.