Ostomy Closures in Children: Variations in Perioperative Care Do Not Change the Outcome

详细信息    查看全文

• 作者：Yusuf Hakan Çavuşoğlu ; Ayşe Karaman ; Çağatay Evrim Afşarlar…
• 关键词：Ostomy ; Colorectal surgery ; Treatment outcome ; Antibiotic prophylaxis ; Surgical wound infection ; Anastomosis ; Surgical
• 刊名：Indian Journal of Surgery
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：77
• 期：3-supp
• 页码：1131-1136
• 全文大小：134 KB
• 参考文献：1.Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR (1999) Guideline for prevention of surgical site infection, 1999. Hospital infection control practices advisory committee. Infect Control Hosp Epidemiol 20(4):250–278. doi:10.​1086/​501620 , quiz 279–280CrossRef PubMed
  2.Menzies D, Parker M, Hoare R, Knight A (2001) Small bowel obstruction due to postoperative adhesions: treatment patterns and associated costs in 110 hospital admissions. Ann R Coll Surg Engl 83(1):40–46PubMed PubMedCentral
  3.Sangkhathat S, Patrapinyokul S, Tadyathikom K (2003) Early enteral feeding after closure of colostomy in pediatric patients. J Pediatr Surg 38(10):1516–1519CrossRef PubMed
  4.Kaiser AM, Israelit S, Klaristenfeld D, Selvindoss P, Vukasin P, Ault G, Beart RW (2008) Morbidity of ostomy takedown. J Gastrointest Surg 12(3):437–441. doi:10.​1007/​s11605-007-0457-8 CrossRef PubMed
  5.Parks SE, Hastings PR (1985) Complications of colostomy closure. Am J Surg 149(5):672–675CrossRef PubMed
  6.Leong G, Wilson J, Charlett A (2006) Duration of operation as a risk factor for surgical site infection: comparison of English and US data. J Hosp Infect 63(3):255–262. doi:10.​1016/​j.​jhin.​2006.​02.​007 CrossRef PubMed
  7.Boland E, Hsu A, Brand MI, Saclarides TJ (2007) Hartmann’s colostomy reversal: outcome of patients undergoing surgery with the intention of eliminating fecal diversion. Am Surg 73(7):664–667, discussion 668PubMed
  8.Guenaga KF, Matos D, Wille-Jorgensen P (2011) Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev 9, CD001544. doi:10.​1002/​14651858.​CD001544.​pub4 PubMed
  9.Wille-Jorgensen P, Guenaga KF, Matos D, Castro AA (2005) Pre-operative mechanical bowel cleansing or not? An updated meta-analysis. Color Dis 7(4):304–310. doi:10.​1111/​j.​1463-1318.​2005.​00804.​x CrossRef
  10.Breckler FD, Rescorla FJ, Billmire DF (2010) Wound infection after colostomy closure for imperforate anus in children: utility of preoperative oral antibiotics. J Pediatr Surg 45(7):1509–1513. doi:10.​1016/​j.​jpedsurg.​2009.​10.​054 CrossRef PubMed
  11.Verma R, Nelson R (2007) Prophylactic nasogastric decompression after abdominal surgery. Cochrane Database of Syst Rev 3. doi:10.​1002/​14651858.​CD004929.​pub3
  12.Dinsmore JE, Maxson RT, Johnson DD, Jackson RJ, Wagner CW, Smith SD (1997) Is nasogastric tube decompression necessary after major abdominal surgery in children? J Pediatr Surg 32(7):982–984, discussion 984–985CrossRef PubMed
  13.Vermulst N, Vermeulen J, Hazebroek EJ, Coene PP, van der Harst E (2006) Primary closure of the skin after stoma closure. Management of wound infections is easy without (long-term) complications. Dig Surg 23(4):255–258. doi:10.​1159/​000095399 CrossRef PubMed
  14.Bischoff A, Levitt MA, Lawal TA, Pena A (2010) Colostomy closure: how to avoid complications. Pediatr Surg Int 26(11):1087–1092. doi:10.​1007/​s00383-010-2690-6 CrossRef PubMed PubMedCentral
  15.Chandramouli B, Srinivasan K, Jagdish S, Ananthakrishnan N (2004) Morbidity and mortality of colostomy and its closure in children. J Pediatr Surg 39(4):596–599CrossRef PubMed
  16.Kiely EM, Spitz L (1985) Layered versus mass closure of abdominal wounds in infants and children. Br J Surg 72(9):739–740CrossRef PubMed
  17.Ortqvist L, Almstrom M, Ojmyr-Joelsson M, Wigander H, Wahrner A, Wester T (2011) Cosmetic and functional outcome after stoma site skin closure in children. Pediatr Surg Int 27(10):1123–1126. doi:10.​1007/​s00383-011-2933-1 CrossRef PubMed
  18.Lewis SJ, Egger M, Sylvester PA, Thomas S (2001) Early enteral feeding versus “nil by mouth” after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ 323(7316):773–776CrossRef PubMed PubMedCentral
  
• 作者单位：Yusuf Hakan Çavuşoğlu (1)
  Ayşe Karaman (1)
  Çağatay Evrim Afşarlar (1)
  İbrahim Karaman (1)
  Derya Erdoğan (1)
  İsmet Faruk Özgüner (1)
  
  1. Department of Pediatric Surgery, Dr. Sami Ulus Maternity and Children’s Hospital, 06080, Altındağ, Ankara, Turkey
  
• 刊物主题：Surgery; Pediatric Surgery; Neurosurgery; Plastic Surgery; Cardiac Surgery; Thoracic Surgery;
• 出版者：Springer India
• ISSN：0973-9793

文摘

This study aimed to evaluate ostomy closure applications and outcomes and determine the effect of personal differences among surgeons on patient postoperative course. Ninety-eight patients who underwent elective ostomy (ileostomy and colostomy) closure for 8 years at a pediatric surgery training department were investigated. Postoperative complications included superficial surgical site infection (SSI; 9.4 %), organ/cavity infection (1 %), small bowel adhesions (8.2 %), and incisional hernia (1 %). SSI and postoperative complications were not affected by the preoperative antibiotic regimen used. Operation duration, pre- and postoperative antibiotic use durations, postoperative inpatient period, ostomy type, primary diagnosis, performance of abdominal exploration, SSI, and postoperative complications were not significantly different. However, the time of nasogastric (NG) tube withdrawal, time to oral feeding initiation, abdominal closure method used, and preoperative antibiotic regimen were significantly different among different surgeons. We conclude that while surgeons used different preoperative antibiotic regimens and abdominal closure methods and stipulated different times for NG tube withdrawal and oral feeding initiation, the postoperative course and prognosis were unaffected Thus, the pre- and postoperative inpatient period and antibiotic use duration can be decreased in children by procedure standardization using practice guidelines; the procedures can also be performed with a more aesthetic, acceptable incision.