Colostomy closure: how to avoid complications

Purpose: Colostomy is an operation frequently performed in pediatric surgery. Despite its benefits, it can produce significant morbidity. In a previous publication we presented our experience with the errors and complications that occurred during cases of colostomy creation. We now have focused in the morbidity related to the colostomy closure. The technical details that might have contributed to the minimal morbidity we experienced are described. Methods: The medical records of 649 patients who underwent colostomy closure over a 28-year period were retrospectively reviewed looking for complications following these procedures. Our perioperative protocol for colostomy closure consisted in: clear fluids by mouth and repeated proximal stoma irrigations 24 h prior to the operation. Administration of IV antibiotics during anesthesia induction and continued for 48 h. Meticulous surgical technique that included: packing of the proximal stoma, plastic drape to immobilize the surgical field, careful hemostasis, emphasis in avoiding contamination, cleaning the edge of the stomas to allow a good 2-layer, end-to-end anastomosis with separated long-term absorbable sutures, generous irrigation of the peritoneal cavity and subsequent layers with saline solution, closure by layers to avoid dead space, and avoidance of hematomas. No drains and no nasogastric tubes were used. Oral fluids were started the day after surgery and patients were discharged 48-72 h after the operation. Results: The original diagnoses of the patients were: anorectal malformation (583), Hirschsprung\u27s disease (53), and others (13). 10 patients (1.5%) had complications: 6 had intestinal obstruction (5 due to small bowel adhesions, 1 had temporary delay of the function of the anastomosis due to a severe size discrepancy between proximal and distal stoma with a distal microcolon) and 4 incisional hernias. There were no anastomotic dehiscences or wound infection. There was no bleeding, no anastomotic stricture and no mortality. Conclusion: Based on this experience we believe that colostomy closure can be performed with minimal morbidity provided a meticulous technique is observed. © 2010 The Author(s)

Connectivity within and among a Network of Temperate Marine Reserves

Networks of marine reserves are increasingly being promoted as a means of conserving marine biodiversity. One consideration in designing systems of marine reserves is the maintenance of connectivity to ensure the long-term persistence and resilience of populations. Knowledge of connectivity, however, is frequently lacking during marine reserve design and establishment. We characterise patterns of genetic connectivity of 3 key species of habitat-forming macroalgae across an established network of temperate marine reserves on the east coast of Australia and the implications for adaptive management and marine reserve design. Connectivity varied greatly among species. Connectivity was high for the subtidal macroalgae Ecklonia radiata and Phyllospora comosa and neither species showed any clear patterns of genetic structuring with geographic distance within or among marine parks. In contrast, connectivity was low for the intertidal, Hormosira banksii, and there was a strong pattern of isolation by distance. Coastal topography and latitude influenced small scale patterns of genetic structure. These results suggest that some species are well served by the current system of marine reserves in place along this temperate coast but it may be warranted to revisit protection of intertidal habitats to ensure the long-term persistence of important habitat-forming macroalgae. Adaptively managing marine reserve design to maintain connectivity may ensure the long-term persistence and resilience of marine habitats and the biodiversity they support

Absence of a large brown macroalga on urbanized rocky reefs around Sydney, Australia, and evidence for historical decline

Loss of habitat-forming algae is increasingly prevalent in temperate marine ecosystems. Here, we document absence of an important habitat-forming macroalga, Phyllospora comosa (Labill.) C. Agardh, along an urbanized coast in New South Wales (NSW), Australia. Dense Phyllospora canopies were common on shallow sublittoral reefs north and south of Sydney. In contrast, we did not find a single individual along ∼70 km of rocky coastline in the Sydney metropolitan region, despite historical evidence to suggest that it was very common half a century ago. Recolonization of this important habitat-forming alga has not occurred on Sydney reefs despite improved water quality, protection of its habitat, and frequent long-distance dispersal of Phyllospora wrack. While there are obvious limitations, historical information can be useful for identifying potential shifts in community structure to increase our understanding of contemporary ecological patterns. © 2008 Phycological Society of America

Microsatellite markers developed through pyrosequencing allow clonal discrimination in the invasive alga Caulerpa taxifolia

Polymorphic microsatellites were developed for the invasive green algae Caulerpa taxifolia using next generation DNA sequencing. Results showed a limited rate of microsatellites for the amount of sequences, possibly explaining failure of previous attempts for microsatellite development through classical methods. Eight polymorphic loci were selected that exhibited polymorphism and a null or negligible rate of amplification failure. The number of alleles per locus ranged from two to seven. The reconstruction of Multi Locus Genotypes and the heterozygosity and departure from Hardy–Weinberg equilibrium confirmed the influence of clonal reproduction and showed the usefulness of this set of markers to successfully discriminate clonal lineages and analyze the clonal and genetic composition of algal beds. These markers will be used to further investigate the clonal composition and genetic structure in populations of C. taxifolia and to attempt retracing the origin of and pathways followed by invasive clonal lineages