Ostomy Usage for Colorectal Trauma in Combat Casualties

Area of Science:

• Surgery
• Trauma Surgery
• Gastrointestinal Surgery

Background:

• Diverting ostomies are crucial for reducing morbidity and mortality in combat trauma.
• Factors influencing ostomy type and permanence in combat casualties are not well understood.

Purpose of the Study:

• To examine ostomy usage patterns and reversal rates in combat trauma patients.
• To identify factors influencing ostomy type selection and permanence.

Main Methods:

• Retrospective review of 202 combat casualties treated between 2003 and 2015.
• Collected data on clinical and demographic factors, ostomy type, and reversal status.

Main Results:

• End colostomies were most frequent (N=149), followed by loop colostomies (N=34) and end ileostomies (N=19).
• Damage control laparotomy (DCL) was associated with lower rates of loop colostomy formation.
• Ostomy reversal occurred in 89.9% of patients; pelvic fractures were linked to permanent ostomies, but no factor independently predicted permanence.

Conclusions:

• Damage control laparotomy and severe perineal injury significantly influence ostomy type.
• The majority of combat trauma patients undergo ostomy reversal.
• Findings offer insights into fecal diversion management for military surgeons treating combat casualties.