Comparative Study Between Stoma and Primary Anastomosis in Emergency Gut Surgery

Abstract

Background: Emergency bowel surgery is frequently required for intestinal perforation, obstruction, and trauma, and postoperative wound morbidity remains a major driver of prolonged hospitalization and adverse outcomes. Objective: To compare postoperative wound infection and wound dehiscence rates between stoma creation and primary anastomosis in emergency gut surgery. Methods: This comparative non-randomized clinical study was conducted at the Department of Surgery, Bolan Medical College/Sandeman Provincial Hospital, Quetta, from 04 January 2025 to 04 July 2025. Eighty-six patients undergoing emergency gut surgery were enrolled consecutively and grouped according to operative procedure: stoma creation (Group A, n=43) or primary anastomosis (Group B, n=43). Patients were followed during admission and at one week and one month postoperatively to determine wound infection and wound dehiscence. Between-group comparisons were performed using chi-square tests, and effect sizes were expressed as risk ratios with 95% confidence intervals. Results: Mean age was 37.3±9.9 years, with no significant difference between groups (p=0.231). Wound dehiscence occurred in 25.6% of Group A versus 34.9% of Group B (p=0.348; RR 0.73, 95% CI 0.38–1.41). Wound infection occurred in 4.7% of Group A versus 30.2% of Group B (p=0.002; RR 0.15, 95% CI 0.04–0.64). Conclusion: Stoma creation was associated with significantly lower postoperative wound infection compared with primary anastomosis, while wound dehiscence rates were comparable.