Complications Following Early and Delayed Ileostomy Closure: An Interventional Study

Abstract

Introduction: Ileostomy is used frequently now-a-days for various surgical conditions. Patients with ileostomies face several problems like physiological, psychological and social problems. Moreover, a stoma can also lead to different complications. Surgeries for reversal of stomas can also lead to different complications, leading to increased morbidity and mortality. Aim: To find significant differences, if any, in morbidity and mortality between patients of early and delayed ileostomy closure. Materials and Methods: In this interventional study, 100 patients were recruited into two groups of i.e., 40 in early ileostomy closure group and 60 in the delayed ileostomy closure group. Their baseline characteristics were compared to find out the comparability between the two groups. The patients were followed-up over a period of time to find out complications such as skin excoriation, wound dehiscence, wound infection, anastomotic leakage, faecal fistula etc. Student’s t-test was applied for continuous variables and for discrete variables, Chi-square test was applied to find out whether there was any statistically significant difference between the two groups. A p-value<0.05 was considered significant. Results: Out of total 40 patients, in the early closure group 5 (12.5%) of patients closure group developed skin excoriation, whereas 10 (25%) developed wound infection and 10% of the patients developed incisional hernia. Skin excoriation amongst delayed closure group was noticed in 21 (35%), wound infection in 6 (10%) and Incisional hernia in 1 (1.7%) patient. Skin excoriation was significantly less among early closure group with an OR of 0.27 (0.09-0.78). Duration of stay in the hospital was significantly less among the early closure group (24.92±5.12) days compared to the delayed closure group (41.43±12.29) days (p<0.001). One patient expired due to sepsis after on 13th postoperative day, who was in the delayed closure group. Conclusion: Skin excoriation was significantly less amongst the patients of the early ileostomy group. Hence, early ileostomy closure can reduce the complications of ileostomy and the duration of carrying the ileostomy.

Keywords

• wound excoriation
• infection
• incisional hernia
• morbidity
• postoperative complications
• wound infection