Colostomy closure. Morbidity reduction employing a semi-standardized protocol.

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