SciELO - Scientific Electronic Library Online

 
vol.51 número3Analysis of epidemiology, lesions, treatment and outcome of 354 consecutive cases of blunt and penetrating trauma to the chest in an African setting índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados

Articulo

Indicadores

Links relacionados

  • En proceso de indezaciónCitado por Google
  • En proceso de indezaciónSimilares en Google

Compartir


South African Journal of Surgery

versión On-line ISSN 2078-5151
versión impresa ISSN 0038-2361

Resumen

PRICE, C E; COX, S  y  RODE, H. The use of diverting colostomies in paediatric peri-anal burns: Experience in 45 patients. S. Afr. j. surg. [online]. 2013, vol.51, n.3, pp.102-105. ISSN 2078-5151.

BACKGROUND: Peri-anal burns are common in children. Continual exposure to enteric organisms may lead to a contaminated burn wound, invasive sepsis, graft loss, scar contracture, anal and urinary malfunction, and delayed discharge from hospital. Use of a temporary diverting colostomy has been advocated to reduce complications. OBJECTIVES: To review the incidence, indications, methods, bacteriology, therapeutic effects and outcomes of colostomy for peri-anal burns. METHODS: A prospective study of children with peri-anal burns and stomas over a 17-year period. Prophylactic or therapeutic faecal diversion was achieved by temporary, divided sigmoid end-colostomy with Hartmann's closure of the distal end. RESULTS: Between 1995 and 2012, 45 children with peri-anal burns received a colostomy. The mean total body surface area burned was 35% (range 3 - 80%). There were 28 flame burns, 16 fluid burns and 1 contact burn. Prophylactic colostomies were performed in 29 children, on average on day 6 after admission, and therapeutic colostomies to counteract deep wound infection and septicaemia in 16 patients, on average on day 24. In all but 2 cases there was a marked improvement in clinical appearance, graft take and healing. The bacterial profile changed from gut-derived organisms to Pseudomonas aeruginosa or no pathogens. Complications occurred in 5 patients (11.1%). Three stomas required manual reduction. Two children died of established septic shock, compounded by stomal dehiscence in 1 case. Reversal of the colostomy was performed on average at 4 months. CONCLUSION: Diverting colostomy has therapeutic advantages in a select group of paediatric burns patients in whom continual faecal soiling poses a threat to both graft and life.

        · texto en Inglés     · Inglés ( pdf )

 

Creative Commons License Todo el contenido de esta revista, excepto dónde está identificado, está bajo una Licencia Creative Commons