Early Colostomy Formation Can Improve Independence Following Spinal Cord Injury and Increase Acceptability of Bowel Management

Topics in Spinal Cord Injury Rehabilitation, 2019 · DOI: 10.1310/sci18-00026 · Published: December 12, 2018

Spinal Cord Injury Surgery Gastroenterology

Simple Explanation

Spinal cord injuries often lead to bowel dysfunction, requiring management through various methods. When these methods fail, a colostomy, a surgical procedure creating an opening in the abdomen for waste removal, is considered. This study explores the reasons why some patients with SCI choose to have a colostomy early in their rehabilitation, compared to those who choose it later, and assesses the safety and effectiveness of early colostomy. The research indicates that early colostomy can be a safe and effective option for improving independence and making bowel care more manageable and acceptable for newly injured patients.

Study Duration

2005-2016

Participants

72 patients with SCI

Evidence Level

Not specified

Key Findings

1
Patients choosing early colostomy prioritize reducing reliance on caregivers and increasing independence, while those choosing it later do so to resolve existing bowel care problems.
2
Early surgical complication rates were low and comparable between early and later colostomy groups.
3
Colostomy formation led to 20.8% of all patients gaining independence with bowel care.

Research Summary

This retrospective study examined patients with SCI who underwent colostomy to manage bowel dysfunction, comparing those who chose it early versus later after their injury. The study found that early colostomy is a safe and effective option that can improve independence and quality of life for patients with SCI. The findings suggest a paradigm shift in thinking about colostomy, from a last resort to a proactive choice for gaining independence and improving bowel care management.

Practical Implications

Reconsider Bowel Care Approach

Healthcare professionals should reconsider the traditional approach to bowel care, where colostomy is seen as a last resort. Early colostomy should be presented as a viable option for suitable patients.

Improve Patient Education

Patients with SCI should be educated about the potential benefits of early colostomy in terms of independence, quality of life, and ease of bowel management.

Tailor Interventions

Bowel care interventions should be tailored to individual patient needs, considering psychological and social factors, and the potential for returning to work and social activities.

Study Limitations

1
Stoma department patient records were more extensive for those operated on since 2013 when records became electronic
2
The method of gathering data from medical and nursing notes gives only the recorded professional understanding of patient experiences.
3
It is not yet known whether more bowel-related complications will arise over the longer term.

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