Background: There are numerous and frequent common complications following construction of large bowel stomas, which may lead to significant morbidity and mortality. The overall morbidity from colostomy has been reported to be as high as 42-75%. Aims of the study: •To study the complications of colostomy (immediate, early & late) taking into consideration the site and types of the colostomy. •To determine the types and sites of colostomy in anorectal malformation and Hirschsprung’s disease. •To study some associated risk factors in colostomy with anorectal malformation and Hirschsprung’s Disease. •To estimate the rate of death for performed colostomies in anorectal malformation and Hirschsprung’s disease. Patients and methods: A cross-sectional prospective study included a total number of (160) temporary colostomies were performed for neonates, infants and children in the pediatric surgical department of Children Welfare Teaching Hospital in Baghdad over a period of three years from January 2008 to January 2011. A standardized data sheets were prepared for collecting the information including age, sex, associated congenital anomalies and colostomy data (type, site, indication, and complication). Results: Most of the colostomies were done in the neonatal period (69.4%) and mainly for imperforate anus (46.9%) while colostomies that were performed in infancy (26.2%) were done mainly for Hirschsprung’s disease (18.1%). The most common type of stoma was right loop transverse colostomy for Hirschsprung’s disease (31.2%) and pelvic loop for imperforate anus (42.5%). 107 different complications developed in 71 patients as a result of colostomy formation and the most common complications were stomal prolapse, skin excoriation, wound sepsis, stomal stenosis, retraction, and bleeding. The mortality rate was 7.5% (12 patients); 4 patients had Hirschsprung’s disease and 8 patients had an imperforate anus.Conclusion: Hirschsprung’s disease and imperforate anus were the most common indications of stoma formation in pediatric age group. The right transverse loop and pelvic loop colostomy were the commonest stoma that was performed with a high rate of complications.

Background: Perforated appendicitis is a serious complication of acute appendicitis that usually occurs due to over delay in presentation, diagnosis, and surgical treatment. Wound infection is one of the important sequelae of perforated appendicitis. Method of the wound closure in perforated appendicitis is a critical factor that affects the incidence of wound infection and there is continuing controversy about the best method.Methods: 362 patients with a diagnosis of acute appendicitis were enrolled in a prospective randomized study that extended over three years. The intraoperative gross pathological state of the appendix was recorded as either negative or uncomplicated or perforated appendicitis. The relationship between the wound infection with each one of the three methods of wound closure (primary closure, open wound with delayed primary closure and partial wound closure) had been reported. The hospital stays were recorded for each method.Results: 18.78% of appendectomy was appendicitis negative, 62.98% uncomplicated appendicitis and 18.23% with perforated appendicitis. In the perforated appendicitis cases, Primary wound closure was used in 36.36%, open method and delay primary closure in 18.18% and partial wound closure in 45.45%. The wound infection rates were 37.5%, 16.66% and 13.33% in primary wound closure, open wound with delayed primary closure and partial wound closure respectively. Length of hospital stays were 7 days, 8 days and 4 days respectively.Conclusions: partial wound closure is superior to other methods of wound closure, which are primary wound closure and open wound with delayed primary wound closure.