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Colostomy: its place in the management of colorectal injuries in civilian practice.

The treatment of 23 patients who sustained colorectal perforating injuries over four year period were reviewed. Twelve out of 14 (85.7%) had excellent results with one stage (primary) closure while two patients (14%) died from complications of peritoneal sepsis and faecal fistula. The remaining nine patients were treated with colostomy. Only one developed wound sepsis not attributable to the colostomy. There were no deaths. The colostomy patients stayed in hospital, an average of 32 days as opposed to 15 days stay by those who had primary repair. It is concluded that primary closure is safe and cheap but the decision to do it must be taken in consideration to the environment in which one practices.