Colostomy closure following trauma.

All patients undergoing a post-traumatic colostomy closure at the New Jersey Medical School Affiliated Hospitals from 1974 to 1978 were studied for the effect of timing and technique of colostomy closure on postoperative complications. Analysis showed that patients in whom the colostomy was closed between six weeks and three months had a significantly shorter operating time when compared with those operated upon less than six weeks after formation of the colostomy. They also had a lower infection rate, shorter time to intestinal function and shorter postoperative hospital stay. Patients undergoing closure of a loop colostomy were analyzed for the technique of closure. Those patients undergoing a simple loop closure had a significantly shorter length of operation time, lower infection rate and shorter time to return of intestinal function. The safest time to close a colostomy created for trauma is between six weeks and three months. The reason for the increased complication rate in the early group is technical difficulty due to incomplete resolution of the edema and inflammatory reaction. Every effort should be made to close a loop colostomy without resorting to resection.