Primary closure of stoma site wounds after ostomy takedown
Dawn M Harold1, Eric K Johnson, Julie A Rizzo
1Department of Surgery, Madigan Army Medical Center, Fort Lewis, WA, USA.
Background:
Ostomy reversal is considered a contaminated surgery and, thus, primary closure is believed to increase infection. Various closure techniques have been described and postulated to be superior to primary closure in regards to decreasing stoma site wound infections. The literature has varied in its support for this hypothesis.
Methods:
A retrospective review was performed evaluating several variables including stomal closure method, patient demographics, steroid/immunosuppressant use, chemotherapy or radiation, perioperative antibiotics, and surgical indication to determine whether there was any association with the development of wound infections.
Results:
Of 75 patients undergoing ostomy reversal, delayed primary closure/packing/secondary intention was used in 49 (65%), and 26 underwent primary closure (35%). Four patients (5.3%) developed stoma site infections; all had delayed primary closure or packing of their wound (P = .39). No variable was associated significantly with an increased risk of stoma site wound infections.
Conclusions:
Primary closure does not increase the rate of infection.
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