Morbidity reduction employing a semi-standardized protocol

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Abstract
To evaluate a semistandardized protocol for colostomy closure, the cases of 166 consecutive patients from 1974-1981 were analyzed retrospectively. There were 17 complications (17/166); the overall morbidity rate was 2.4%. A significantly increased incidence of major morbidity and septic complications was associated with colostomies closed at an interval of < 8.5 wk from formation (P .ltoreq. 0.001). Simple transverse colostomy closure vs. resection and end-to-end anastomosis did not result in increased morbidity (P .ltoreq. 0.1). The wound infection rate was 1.2% (2/166) with 135/166 wounds closed primarily or primarily over a subcutaneous drain, thus rendering primary wound closure safe and desirable.