An Easy Solution for the Diverting Loop Colostomy: Our Technique

Background: The loop colostomy is one of the most popular techniques used as a protective maneuver for a distal anastomosis and/or temporary fecal diversion. We are introducing the use of a full thickness skin bridge under the large bowel instead of a glass rod which alleviates problems such as protrusion of the large bowel, retraction of the bowel into the abdomen after removing the rod and hindering proper application of a colostomy bag over the stoma.
Methods: Seventeen patients needing double barrel colostomy for complete diversion of fecal material were selected using loop colostomy with skin bridge. Three patients had Fournier's gangrene and 14 had penetrating rectal injury. Omega loop colostomy with a full thickness skin bridge was performed for fecal diversion.
Results: All of the 17 patients had gas passing and full passage of fecal material within 3 days postoperatively. No case of skin necrosis and stitch abscess was encountered. No parastomal hernia or large prolapse was noted until healing was completed and patients were discharged and after at least 8 weeks and in Fournier's gangrene somewhat longer, the loop colostomy was closed without the need for formal laparotomy and without any case of anastomotic leak.
Conclusion: In this study we confirmed that diverting loop colostomy using a skin bridge is a safe, rapid and easy to manage colostomy technique which gives complete diversion similar to double barrel colostomy without the need of performing a laparotomy for closure of the colostomy.

Keywords
Penetrating rectal injury, Fournier's gangrene, Diverting loop colostomy, Skin bridge