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Published on: July 4, 2019

Wound infection following stoma takedown: primary skin closure versus subcuticular purse-string suture

Thao T Marquez1, Dimitrios Christoforidis, Anasooya Abraham

  • 1Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, 420 Delaware Street SE, MMC 450, Minneapolis, MN 55455, USA. tran0360@umn.edu

World Journal of Surgery
|August 13, 2010
PubMed

Insights

A skin-approximating purse-string closure technique for stoma closure resulted in fewer surgical site infections (SSI) compared to primary skin closure. Further randomized trials are recommended to confirm these findings.

Area of Science:

  • Surgical Innovation
  • Wound Healing
  • Infection Control

Background:

  • Stoma closure is linked to a high incidence of surgical site infections (SSI).
  • The optimal technique for stoma site skin closure remains a subject of debate.
  • This study aimed to compare SSI rates between two distinct stoma closure methods.

Purpose of the Study:

  • To compare the incidence of surgical site infections (SSI) following stoma closure using primary skin closure (PC) versus a skin-approximating, subcuticular purse-string closure (APS).

Main Methods:

  • A retrospective assessment of consecutive patients undergoing stoma closure between 2002 and 2007.
  • Exclusion criteria included new stoma creation at the same site or absence of wound closure.
  • Surgical site infection (SSI) was the primary endpoint, assessed per CDC guidelines.

Main Results:

  • The study included 61 patients in the primary closure (PC) group and 17 in the approximating, subcuticular purse-string (APS) group.
  • The overall SSI rate was 18% (14 of 78 patients).
  • All SSIs occurred in the PC group (14 of 61), with no SSIs reported in the APS group (0 of 17), showing a statistically significant difference (p=0.03).

Conclusions:

  • The skin-approximating, subcuticular purse-string closure technique appears to reduce SSI rates compared to primary skin closure.
  • Further randomized controlled trials are warranted to validate these findings.
  • Future research should also evaluate other outcomes like healing time, cost-effectiveness, and patient satisfaction.
Abstract

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