Is a Diverting Colostomy Required After Repair of Obstetric Ano-rectal Injuries?

摘要

Injuries to the ano-rectum may occur during vaginal deliveries. Occasionally, colostomies are created in these patients in order to prevent contamination of the perineal repair. We explore the factors that assist in making the decision for a colostomy. Introduction Injuries to the ano-rectum may occur during vaginal deliveries. Occasionally, colostomies are created in these patients in order to prevent contamination of the perineal repair. We explore the factors that assist in making the decision for a colostomy. Discussion Between 0.2% 1 and 6% 2 of women sustain injury to the ano-rectum during vaginal delivery. These injuries are classified as third degree lacerations when the external anal sphincters are lacerated, and fourth degree when the ano-rectal mucosa is breached. 3,4,5 At a recent consensus meeting, several experts supported the use of a more descriptive classification proposed by Sultan et al. 6 where third degree injuries are sub-classified according to the depth of the laceration through the anal sphincters (Table 1).