Comparative study between different methods in the treatment of traumatic colonic injuries in normal colon

Thirty two patients with traumatic colonic injury were collected from Ain Shams University Hospitals, Naser Institute Hospital and Al Helal Hospital. Associated injuries, length of operative procedure, wounding agent, length of hospital stay, method of treatment and Septic complications were evaluated. According to the Penetrating Abdominal Trauma Index [PATI] Fourteen patients were treated with colostomy at the site of injury, three with diverting colostomy proximal to repair site, fourteen with primary repair and one patient with exteriorization and early drop back. Primary repair was confinied to young adult patients with minimal fecal contamination, presented within 8 hours of injury which was caused by low velocity injury [stab wound], did not need blood transfusion and were haemodynamically stable. Overall septic morbidity was 7 out of 32 [22%] patients. No statistically significant difference was found in morbidity between colostomy 95 patients out of 17 [29%] and repair [3 patients out of 14-21%]. The only patient with exteriorization repair has no morbidity. No deaths were reported among the 32 patients studied. Sixteen out of the seventeen colostomies [93%] were later closed with morbidity in 3 patients out of 16 [18%]. The mean length of stay for Iry repair patients was 10.3+3.8 days, counting days for both initial and colostomy closure admissions [P < 0.05]. This study indicated that Iry repair doesn't carry an increased risk of septic complications in well chozen patients and saves the patient the significant risk and increased hospital stay of colostomy closure