Outcome of colostomy closure with different skin closure techniques in a developing country.
BACKGROUND
Colostomy site, which is a potentially contaminated wound, is traditionally closed with interrupted skin stitches and placement of intraperitoneal or parietal or both drains; often with poor cosmetic outcome in our country. This study aims at prospective evaluation of colostomy closure wounds by different techniques.


METHODS
This study was carried out in all infants and children with colostomy (for different pathologies) admitted for colostomy closure in our institute from August 1, 2006 to February 29, 2008. Patients were divided into two groups: Group A with colostomy closure without any drain and subcuticular skin closure and Group B with colostomy closure with both intraperitoneal and parietal drain and interrupted skin closure. Patient's details, including age, sex, body weight, diagnosis, preoperative bowel preparation, peroperative antibiotics, postoperative wound infection, anastomotic leaks, duration of hospitalisation and postoperative follow-up for wound assessment, were recorded. By the end of February 2008, 151 cases of colostomy closure were recorded, 70 in Group A and 81 in Group B.


RESULTS
Statistical analysis of the data showed no statistically significant difference in wound infection and anastomotic leak between the two groups. On postoperative follow-up, wound assessment showed significantly better cosmesis in the no drain subcuticular group.


CONCLUSIONS
This study shows that closing colostomies without any drain and subcuticular skin closure does not result in any increased incidence of wound infection and has better cosmetic results.
Shukla
R M
RM
Department of Paediatric Surgery, Nil Ratan Sircar Medical College and Hospital, Kolkata, India. rammohanshukla@yahoo.co.in
Tripathy
B B
BB
Mukhopadhyay
B
B
Chattopadhyay
A
A
Saha
K
K
Basu
K Saha
KS
D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003125:Colostomy / Q000009:adverse effects* / Q000379:methods; D003906:Developing Countries; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D011446:Prospective Studies; D017678:Sex Distribution; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing
D000890:Anti-Infective Agents