Aliyah Lockhat1, Guen Kernaleguen2, Bryan J Dicken3, Michael van Manen4. 1. Department of Pediatrics, University of Alberta, Edmonton, AB, Canada. 2. Alberta Health Services, Edmonton, AB, Canada. 3. Division of Pediatric Surgery, University of Alberta Edmonton, AB, Canada. 4. Department of Pediatrics, University of Alberta, Edmonton, AB, Canada. Electronic address: michaelv@ualberta.ca.
Abstract
BACKGROUND: Neonatal ostomies, either temporary or permanent, are created for numerous reasons. Limited attention has been given to understanding what factors might place infants at risk for surgical wound complications. PURPOSE: The purpose of the study is to identify factors associated with risk of significant abdominal wound complications (wound dehiscence and wound infection) following neonatal ostomy creation. METHODS: This is a retrospective chart review of infants undergoing ostomy between January 2009 and December 2013 at the University of Alberta Hospital. MAIN FINDINGS: 66 infants were identified of which 18.2% (12/66) had wound complications. Variables associated with wound dehiscence included: findings of bowel necrosis during laparotomy (7/9 wound dehiscence, 18/57 none, p=0.008), perioperative sepsis (3/9 wound dehiscence, 3/57 none, p=0.006), and perioperative blood transfusion (9/9 wound dehiscence, 30/57 none, p=0.007). Wound infection was not predicted by any variables collected. CONCLUSIONS: Neonates undergoing creation of an ostomy appear to be at substantial risk for wound complications. As wound complications are significant issues for infants undergoing surgery, emerging strategies should be explored to either avoid ostomy creation or promote wound healing.
BACKGROUND:Neonatal ostomies, either temporary or permanent, are created for numerous reasons. Limited attention has been given to understanding what factors might place infants at risk for surgical wound complications. PURPOSE: The purpose of the study is to identify factors associated with risk of significant abdominal wound complications (wound dehiscence and wound infection) following neonatal ostomy creation. METHODS: This is a retrospective chart review of infants undergoing ostomy between January 2009 and December 2013 at the University of Alberta Hospital. MAIN FINDINGS: 66 infants were identified of which 18.2% (12/66) had wound complications. Variables associated with wound dehiscence included: findings of bowel necrosis during laparotomy (7/9 wound dehiscence, 18/57 none, p=0.008), perioperative sepsis (3/9 wound dehiscence, 3/57 none, p=0.006), and perioperative blood transfusion (9/9 wound dehiscence, 30/57 none, p=0.007). Wound infection was not predicted by any variables collected. CONCLUSIONS: Neonates undergoing creation of an ostomy appear to be at substantial risk for wound complications. As wound complications are significant issues for infants undergoing surgery, emerging strategies should be explored to either avoid ostomy creation or promote wound healing.