Abstract
Objective: To compare the primary repair versus colostomy in colonic injuries at tertiary care hospital in terms of morbidity and hospital stay.
Design & duration: This quasi-experimental study was carried out from 27-1-07 to 26-07-07.
Setting: Department of Surgery, Mayo Hospital Lahore.
Patients and methods: Sixty patients presented within 10 hours after penetrating injury and damaged colon part is < 1 cm with minimal faecal contamination, were included in the study. The patients who have injury of > 2 abdominal viscera, frank faecal contamination, shock and immuno-compromised were excluded from the study. Patients were randomly divided in two groups; Group A (Primary repair), Group B (Colostomy), 30 patients in each group. Follow up in group A patients was done twice after 2 weeks and after one month. Follow up in group B was done for multiple times. Initially the visit was advised after every two week until the patient was called back for colostomy closure.
Results: Out of sixty patients, 27 were males and 3 were females in group A and 28 were males and 2 were females in group B with Mean +/- SD ages were 28.9 +/- 8.1 years and 30.1 +/- 14.0 years. Mean hospital stay in group A was 8.9 +/- 3.6 days and in group B was 11.0 +/- 4.7 days. At two week follow up, in group A there was 1 patient of abscess, 1 patient of suture repair leak, 1 patient of sepsis and 2 patients of wound infection. In group B, there were 2 patients of abscess, 1 patient of suture repair leak, 3 patients of sepsis and 4 patients of wound infection.
Conclusion: It is concluded that primary repair was safe and effective treatment modality in the management of colonic injuries as compared to colostomy.