Colostomy in trauma surgery: friend or foe?
Twenty-five patients underwent a colostomy that came to closure. There were eight blunt, 15 penetrating and two impaling injuries. Colostomy-related complications occurred in four patients; two wound infections, one stoma prolapse, one loop obstruction. Closure was performed during a second hospital stay after a standard mechanical bowel preparation and enteral and parenteral broad-spectrum antibiotics perioperatively. The procedure performed by board certified/eligible surgeons, lasted an average of 2.5-3h. Incisional hernias occurred as the only complication in two patients. For certain injuries of the colon, rectum and perineum, diverting colostomy is still the procedure of choice. It can be performed without significant additional morbidity. Subsequent closure in experienced hands does not carry a significant complication rate.
Rehm
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University of Medicine and Dentistry, Robert Wood Johnson Medical School, Camden Cooper Hospital/University Medical Center, New Jersey.
Talucci
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Ross
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D000293:Adolescent; D000328:Adult; D003125:Colostomy / Q000009:adverse effects; D005260:Female; D006547:Hernia; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D014194:Traumatology; D014949:Wounds, Nonpenetrating / Q000601:surgery*; D014950:Wounds, Penetrating / Q000601:surgery*