Johnston LR, et al. - Researchers retrospectively reviewed combat casualties managed with a diverting ostomy who underwent ostomy reversal at their military treatment facility over a 13 year period and searched for the risk factors for complications after ostomy reversal. They recognized ostomy reversal in the combat wounded as a major task with a high complication rate. A shorter interval from ostomy creation to reversal was noted to have an independent association with a reduction in complications. They suggested performing reversal in the three to six month time frame to achieve the lowest rate of complications.

Methods

• Researchers collected demographic and clinical data for all patients and identified post-operative complications.
• Independent risk factors for complications following reversal were identified performing multivariate analysis.
• For 90 day periods of time following ostomy creation, they calculated complication rates and conducted best fit curve analysis.

Results

• Ostomy reversal was performed on 99 patients.
• Post-reversal complications were encountered in 40 patients (40.4%).
• Post-operative complications were observed in independent association with older age (OR=1.11/year; p=0.038), severe perineal injury indication for diversion (OR=4.37; p=0.028), and increased time interval between ostomy creation and reversal (OR=1.005/day; p=0.037), in multivariate analysis.
• In this work, a cubic regression best fit quarterly complication rate data (R₂=0.526, P<0.001) and calculates a minimum complication rate for reversal 90-180 days after ostomy creation.