Floating stoma: An alternative strategy in the context of damage control surgery

Abstract

Introduction Floating stoma (FS) is a strategy to be considered in the context of damage control surgery (DCS). The purpose of this study is to describe the technique used and the results of a series of patients where FS was used. Methods Case series of relaparotomized patients at two emergency services in Temuco, Chile (2005–2014). In all of them, once drainage of septic focus or damage was controlled, the abdomen was left open with a Bogota bag (BB) and FS. Outcome variables were FS indications, morbidity, time to first replacement of BB, definitive maturation of the stoma (DMS), time to withdraw the BB and mortality. Results FS was performed in 46 patients with a mean age of 49.3 ± 21.1 years; 63% were female. The indication of FS was abdominal sepsis by secondary peritonitis (69.6%), abdominal trauma (17.4%), and mesenteric ischemia (13.0%). Morbidity was 37.0%. Median time to first replacement of BB, DMS and time to withdraw the BB were 84 hours, 3.5 days and 49 days, respectively. Mortality was 19.6%. Conclusion FS is a temporary resource reserved for special surgical cases. It is associated with morbidity and mortality inherent with the severity of the patients on whom it can be used.