Are the risks after colostomy closure exaggerated?

One hundred twenty-one patients underwent colostomy closure for trauma. There was no mortality and a 4.9 percent incidence of major morbidity. Although there was no apparent relationship between the interval between colostomy creation and closure, three of the six major complications occurred in patients whose colostomies were closed soon after complicated initial injuries. It is recommended that if the primary operation is complicated by intraabdominal sepsis or major wound problems, 6 months should ensue before attempting closure. Long term follow-up of these patients (mean 39 months) disclosed a low incidence of late complications secondary to colostomy closure. Although the trend toward the increased use of primary repair of colon injuries in selected patients is supported, our study indicates that the risk of colostomy closure has been exaggerated and should not be a factor in the decision to create a colostomy after colon trauma.