Predictors of morbidity in patients undergoing diverting colostomy for non-healing sacral, perineal or ischial wounds

Abstract

Abstract Background The treatment of non-healing sacral, perineal, or ischial wounds often requires fecal diversion to promote wound healing. The purpose of this study was to identify risk factors for morbidity, rates of colostomy reversal and complications related to type of colostomy. A retrospective chart review was conducted on all patients with non-healing wounds who underwent diverting colostomies. Results Sixty six patients met criteria for inclusion in the study. Complication rates and revision rates were studied. 27% of all stomas required revision. Stoma revision was required in a higher proportion (33%) of all loop colostomies as compared to all end colostomies (10%). During the study period, 26% of diverted patients went on to have a myocutaneous flap. The stoma reversal rate was 5% (3/66). Complications occurred in 32% of patients. The most common complication was parastomal hernia (20%). Other complications included: small bowel obstruction, 8%; stoma prolapse, 6%; stoma bleeding 5%; and stoma retraction, 5%. Patients with loop colostomies had a higher rate of overall complications as compared to end colostomies (37% vs.10%) Conclusions Based on the findings of this study, consideration should be given to fashioning end sigmoid colostomies for fecal diversion in patients with non-healing wounds.