Postoperatively parastomal infection following emergent stoma creation for colorectal obstruction: the possible risk factors.
BACKGROUND
The aim of the present study was to discuss the possible risk factors related to the parastomal infection after the patients received emergent stoma creation in colorectal obstruction that was caused by adenocarcinoma, diverticulitis, or a variety of other miscellaneous causes.


METHODS
A total of 360 patients with colorectal obstruction underwent emergent stoma creation, including diversion and Hartmann's procedure between January 1996 and January 2005. We analyze the patients' records to document the possible risk factors associated with parastomal infection. Patients' demographics, indication for ostomy, ostomy type/location, and risk factors were recorded. Logistic regression was used to calculate adjusted odds ratios. A p value of less than 0.05 was considered significant.


RESULTS
Twenty patients (5.6%) with emergent stoma creation had parastomal infection. Descending colostomy had the highest incidence (6.7%) of parastomal infection, followed by transverse colostomy (6.1%) and ileostomy (3.2%). Significant predictors of parastomal infection as presented with odds ratios and 95% confidence intervals include obstruction period, obesity, operative time, serum albumin, and serum C-reactive protein (CRP). Parastomal infection is also highly associated with abdominal surgical wound infection.


CONCLUSIONS
We concluded that risk factors for parastomal infection include obstruction period, obesity, operative time, serum albumin, and serum CRP. Furthermore, the abdominal surgical wound infection predispose to parastomal infection. Therefore, prolonged and specific antibiotics for results of culture should be used for patients with the above risk factors to prevent parastomal infection.
Liu
Wei-Hsiu
WH
Department of Neurological Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Pai
Lu
L
Wu
Chang-Chieh
CC
Jao
Shu-Wen
SW
Yeh
Chien-Chih
CC
Hsiao
Cheng-Wen
CW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D003108:Colonic Diseases / Q000601:surgery*; D003125:Colostomy / Q000009:adverse effects*; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007415:Intestinal Obstruction / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult