Morbidity reduction employing a semi-standardized protocol

Abstract

To evaluate a semi-standardized protocol for colostomy closure, the cases of 166 consecutive patients from 1974 through 1981 were analyzed retrospectively. There were 17 complications (17/166); overall morbidity rate was 2.4 per cent. A significantly increased incidence of major morbidity and septic complications was associated with colostomies closed at an interval of less than 8.5 weeks from formation (P less than or equal to 0.001). Simple transverse closure of colostomy versus resection and end-to-end anastomosis did not result in increased morbidity (P less than or equal to 0.1). The wound infection rate was 1.2 per cent (2/166) with 135/166 wounds closed primarily, or primarily over a subcutaneous drain, thus rendering primary wound closure safe and desirable.

Morbimortalidade da reconstrução de transito intestinal colônica em hospital universitário: análise de 42 casos

“…Vários fatores de risco tem sido implicados na literatura no desenvolvimento de complicações após o fechamento de colostomia, por exemplo, experiência do cirurgião (5,11) , doença primária (2) , localização do estoma (12) , técnica operatória (13) e o tempo de intervalo entre a primeira operação e o seu fechamento (3,11,(14)(15)(16) . Infelizmente os resultados são conflitantes entre as séries relatadas.…”

Incidence, risk factors and prevention of stoma site incisional hernias: a systematic review and meta‐analysis

“…Temporary stomas are frequently constructed to defunction a low colorectal anastomosis and during surgery for acute complicated diverticulitis, inflammatory bowel disease and traumatic intestinal injury [1][2][3][4][5][6][7][8]. Subsequent stoma reversal is associated with surgical site infection (SSI), anastomotic leakage, postoperative ileus and development of stoma site or midline incisional hernia (MIH) [9][10][11][12][13]. Stoma site incisional hernia (SSIH) can cause pain, disfiguration, incarceration and strangulation [14,15].…”

Factors affecting temporary stoma outcomes at a major Saudi University Hospital

“…14,15 Multiple factors influencing these complications have been reported including; patient's age >70 years, BMI >30, and the presence of locally advanced malignancies. [3][4][5]8,[16][17][18][19][20][21][22] In addition, prolonged time to closure (more than 6 months) of temporary stomas was found to increase the risk of complications and the length of hospital stay, subsequently worsens the patients' quality of life and raising hospital costs. [6][7][8] Understanding risk factors for the development of these complications would aid in targeting them for preventive measures thus, improve patients' outcomes.…”