Morbidity reduction employing a semi-standardized protocol

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≤0.001). Simple transverse closure of colostomy versus resection and end-to-end anastomosis did not result in increased morbidity (P≤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 Read at the annual meeting of the Southern Medical Association, Atlanta, Georgia, October 30, 1982.