FREQUENCY OF WOUND INFECTION IN EARLY INFECTION IN REVERSAL OF ILEOSTOMY

Background: The reversal of ileostomies carries complications like intestinal hemorrhage, anastomosis leak/fistula,
intra-abdominal abscess, stricture, bowel obstruction, wound infection and stomal site hernia. The commonest
complication of Ileostomy closure is wound infection/sepsis. Wound infection not only prolongs the hospital stay,
increases cost of treatment but can also lead to septicemia and long term complications like incisional hernia.
Objective: The objective of this study was to determine the frequency of wound infection in early reversal of
ileostomy
Materials and Methods: This descriptive, case series study was conducted in Surgical “A” unit-PGMI Lady Reading
Hospital Peshawar from June 2010 to December 2011. Patients requiring ileostomy closure was booked and
admitted through outpatient department for early closure at 4weeks of initial surgery. Informed written consent was
obtained. Pre-operative distal loopogram was done to check any distal pathology like stricture or leakage, presence
exclude such patients. Patients fulfilling inclusion criteria was included in the study. All patients were followed up on
day 14th
, and 30th
after surgery. All cases were evaluated for post-operative fever, pain (in wound), redness, swelling
of wound margins and discharge of pus from wound during stay in the hospital and on follow up visits. Swabs/pus
was taken from all the cases with any of the above findings and was sent to the laboratory for culture. . Data was
stored and analyzed.
Result: There were 121 patients with ileostomy who underwent reversal and were observed for wound infection, in
which 101(83.5%) were male and 20(16.5%) were female patients. Average age was 36.87 years ±16.493SD.
There were total 29(23.9%) wound infections observed. There were 24(19.8%) wound infections observed during
the hospital on 5th
post operation day. After 14th
post op follow up, wound infection was recorded in 4(3.3%) of
patients, while at 30th
day of follow-up it was seen in 1(0.8%) only. Average hospital stay was 4.56 days + 1.102 SD.
Conclusion: Wound infection was observed as comparable to other studies in early reversal of ileostomy. Stoma
reversal can be done safely at an earlier date and its use should be encouraged as routine method.
Key words: Early reversal of ileostomy, Indications, Complications.