A clinical and experimental study of colostomy blood flow and healing after closure

Colostomy blood flow and healing have been studied in both man and rat. Laser Doppler velocimetry (LDV) was used to measure flow and showed a significant difference between colostomy blood flow measured at 1 week and at more than 8 weeks after fashioning (p < 0.002). Hartmann colostomies were constructed in rats and closed at 3 or 6 weeks later. There was a correlation between distal colonic (stump) blood flow and anastomotic bursting pressures 3 days after closure in the 3-week group (r=0.080;p < 0.01). Colostomies closed at 6 weeks were significantly stronger than those closed at 3 weeks (p < 0.02). Collagen concentration in proximal (stoma) colon was higher in the 6-week group compared with the 3-week group prior to anastomosis. There was also a fall in the proximal collagen after anastomosis in both 3-(p < 0.01) and 6-week groups (p < 0.01). Poor blood flow measured by LDV and colonic collagen concentration may predict poor healing after colostomy closure. LDV is a non-invasive technique with clinical application in this field.