Objective: To see if sigmoid end colostomies that were opened immediately carried a higher early morbidity than those in which opening was delayed for 10 days.
Design: Randomised trial.
Setting: University department of surgical gastroenterology.
Subjects: All patients for whom a temporary or permanent end sigmoid colostomy was done between December 1986 and May 1989.
Interventions: 51 patients had their colostomies opened immediately, and in 49 opening was delayed.
Main outcome measures: Presence of ischaemia, retraction, separation or infection, and length of stay in hospital.
Results: Two patients from each group died within the first week; none of the deaths was associated with complications of the colostomy. One patient whose colostomy had been opened immediately developed gangrene of the stoma, and one in whom the opening had been delayed developed retraction. There was no difference between the groups in length of stay in hospital.
Conclusion: As we could find no differences in morbidity whether the colostomy was opened immediately or whether it was delayed, we now recommend that it should be done immediately. The question of late complications (stenosis and hernia), however, cannot be answered yet.