RT Book, Section
A1 Ellison, E. Christopher
A1 Zollinger, Jr., Robert M.
A1 Pawlik, Timothy M.
A1 Vaccaro, Patrick S.
A1 Bitans, Marita
A1 Baker, Anthony S.
SR Print(0)
ID 1187821555
T1 Closure of Colostomy
T2 Zollinger’s Atlas of Surgical Operations, 11e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781260440850
LK accesssurgery.mhmedical.com/content.aspx?aid=1187821555
RD 2024/04/25
AB In  every  instance  an  interlude  of  at  least  12  weeks  should  be  allowed  between  performance  of  a  colostomy  and  its  closure.  This  enables  the  patient's  general  condition  to  improve,  the  site  of  the  colostomy  to  become  walled  off,  local  immunity  to  the  infected  contents  of  the  intestine  to  develop,  any  infection  in  the  wound  to  subside,  and  the  wounds  from  technical  procedures  carried  out  on  the  distal  colon  to  heal.  This  time  may  be  drastically  shortened  if  the  colostomy  was  performed  to  decompress  or  exteriorize  a  traumatized  normal  colon.  Occasionally,  the  colostomy  partially  or  completely  closes  itself  after  the  obstruction  has  been  removed,  which  permits  the  fecal  current  to  return  to  its  normal  route  through  the  site  of  the  anastomosis.  Closure  should  be  delayed  until  the  edema  and  induration  of  the  bowel  about  the  colostomy  opening  have  subsided  and  the  intestine  has  resumed  a  normal  appearance.  The  patency  of  any  anastomosis  of  the  intestine  distal  to  the  colostomy  should  be  ensured  by  contrast  material  study  using  fluoroscopy  or  endoscopy.