Understanding the effects of colostomy-induced alterations on cutaneous immunity

Abstract

Objective. This study describes the immunological response in the dermal layer of the peri-colostomic region, and identifies and quantifies the cellular elements present. Methods. Forty-one patients with colostomies present for more than 8 weeks were included. Thirty-one patients were men (75.6%) and 10 were women (24.4%) with an average age of 49.9 years. Thirty-four patients (82.9%) were classified as surgical risk class I and 7 patients (17.1%) were classified as class II. The data were analyzed statistically using the Mann-Whitney, Kruskal-Wallis, and Dunn tests using 0.05 or 5%. Results. Analysis of the immuno-cellular response regarding the time of permanence of the colostomy showed a significant frequency of T lymphocytes (pan T-CD3) in all the time periods in a significantly superior number (P < 0.001) than the B lymphocytes (CD20) and the T lymphocytes-natural killer (CD57). T-helper cells (CD4) were present in larger numbers in the first three periods. Conclusion. The presence of a colostomy for more than 8 weeks promotes the development of a chronic inflammation and an immuno-cellular response in the dermal layer of the peri-colostomy region. However, its intensity did not demonstrate a statistically significant difference based on time of colostomy existence. The immuno-cellular response in the peri-colostomic dermal area is composed of a major number of T lymphocytes (pan T-CD3) and T lymphocytes-helper (CD4), and is more numerous between the 16th and 20th weeks, whereas, less cellular activity was noted between the 30th and 50th weeks.