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Morbidity of colostomy closure
American Journal of Surgery
|September 1, 1976
Summary
Colostomy closure in 100 patients resulted in high morbidity (28%), including sepsis and bowel obstruction. Alternate techniques for managing colon trauma should be considered to reduce these risks.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Colorectal Surgery
Background:
- Temporary colostomy is frequently employed for colon injury management.
- Colostomy closure is a common surgical procedure following initial management of colon trauma.
Purpose of the Study:
- To evaluate the morbidity associated with colostomy closure.
- To identify risk factors and recommend improvements in managing colon trauma.
Main Methods:
- Retrospective review of 100 patients undergoing colostomy closure.
- Analysis of postoperative complications, including wound infection, abscess, obstruction, and fistula.
Main Results:
- Overall morbidity was 28%, with one postoperative death due to sepsis.
- Significant complications included wound infection (10%), bowel obstruction (7%), and fecal fistula (4%).
- Delayed wound closure was associated with lower wound sepsis rates compared to primary closure.
Conclusions:
- Colostomy closure is associated with considerable morbidity and should be recognized as a significant procedure.
- Alternate management strategies for colon trauma, such as primary repair or exteriorization, should be explored.
- When colostomy is necessary, open, two-layer anastomosis with delayed wound closure is recommended for closure.