Can Protective Colostomy Have a Role in Pressure Injury Management? A Prospective Non-Randomised Controlled Study

The purpose of this article is to evaluate the potential role of a protective colostomy after reconstructive plastic surgery in individuals with spinal cord injury and neurological bowel, where pressure injuries are a serious complication. This began as a case-control observational study. From 2019, the therapeutic protocol was modified, and colostomy was proposed to all individual. 45 people with spinal cord injuries and grade 3 or 4 of pressure injuries were recruited. The experimental group underwent colostomy, while the control group received direct lesion reconstruction. Fisher's exact test and Student's t-test were utilized for group comparison. Primary outcomes included the number of healed ulcers and post-operative infections. The number of lesions healed within 30 days and the rate of flap infections showed significant differences between the two groups. A crucial statistical difference was found (p < 0.05). The complication rate was 44.44% in the control group and 17.65% in the experimental group (p-value < 0.05). Quality of life also showed encouraging results. Protective colostomy may prevent local complications after surgery, reducing long-term hospitalization and healthcare costs. It also may improve individuals' quality of life.