Factors influencing the morbidity of colostomy closure

Abstract

In a series of 80 colostomy closures, a total complication rate of 26% was found, with a wound infection rate of 14% and an anastomotic leak rate of 4%. Patients having preoperative systemic antibiotics had fewer wound infections than those who did not (8% vs 19%). Delayed primary skin closure or closure by secondary intention was associated with less wound morbidity than was primary closure (10% vs. 17%). However, the use of preoperative systemic antibiotics decreased the incidence of wound infection in those having primary skin closure (5% vs. 27%). Patients having diverticular disease had more wound infections (40%) and greater overall morbidity (70%). Older patients had a higher incidence of complications (24% if < 40 yr and 45% if > 50 yr). Closure of left-sided colostomies was associated with a higher infectious complication rate (26% vs 13%). The time interval to colostomy closure altered subsequent morbidity with a waiting period of 1-2 mo. associated with zero complications.