The surgical treatment of civilian penetrating colon injuries has evolved towards the primary repair instead of the 
staged repair with fecal diversion by a proximal colostomy. Septic complications were found equal or less with the former method and unrelated directly to colon suture line disruption. A question is raised why should a colostomy is performed for those injuries. However, certain pre- and post-operative criteria must be taken in consideration. 
Aim of The Work: Evaluation of the indications and technical factors relevant to the outcome of both the staged repair 
with diversion and primary repair of civilian colon injuries. 
Material and Methods: 18 patients with full thickness colon injuries were surgically treated by primary repair or by a 
staged repair and colostomy in a time period between 3/98 – 3/01. Patients were studied in a prospective manner for the preand intra-operative risk factors predisposing to septic complications. The incidence of those complications, colon sutures line integrity and the patient's risk factors were correlated. 
Results: All of the patients have had one or more of risk factors for postoperative septic complications. 14 of the patients underwent primary repair (10 following debridment and 4 following resection). 4 of the patients underwent repair with 
diverting colostomy (2 following debridment and 2 following resection). Complications related to the colon operation 
occurred in 8 cases (7 after primary repair and 1 after colostomy). None of the patients was complicated by colon suture line disruption. 
Conclusion: Septic complications following surgical repair of penetrating colon injuries correlates with a long elapsing 
time between injury and operation, the severity of that injury and the degree of fecal soiling of the peritoneum. It can occur without colon suture line disruption. Severe colon injuries that mandate a resection in patients with risk factors for 
postoperative abdominal sepsis deserve a diverting colostomy.