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Cosmetic and functional outcome after stoma site skin closure in children

Lisa Ortqvist1, Markus Almström, Maria Ojmyr-Joelsson

  • 1Division of Pediatric Surgery, Department of Women's and Children's Health, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden. lisaortqvist@gmail.com

Pediatric Surgery International
|June 1, 2011
PubMed

Insights

Purse-string closure (PSC) offers better cosmetic and functional outcomes for pediatric stoma closure compared to straight closure (SC). Further research with larger sample sizes is recommended to confirm these findings.

Area of Science:

  • Pediatric Surgery
  • Surgical Outcomes
  • Scarring Assessment

Background:

  • Stoma creation is a common surgical procedure in children for various gastrointestinal conditions.
  • Stoma closure techniques aim to minimize functional deficits and cosmetic concerns.
  • Assessing scar quality is crucial for evaluating the success of surgical interventions.

Purpose of the Study:

  • To compare the functional and cosmetic results of straight closure (SC) versus purse-string closure (PSC) for stoma reversal in pediatric patients.
  • To determine if the purse-string closure technique offers superior outcomes in children.

Main Methods:

  • A cohort of 33 pediatric patients who underwent stoma closure using either SC or PSC between 2007 and 2009 were retrospectively studied.
  • The Patient and Observer Scar Assessment Scale (POSAS) and a visual analogue scale (VAS) were used to evaluate scar characteristics (pain, itchiness, color, stiffness, thickness, irregularity) and overall satisfaction.
  • Common indications for stomas included necrotizing enterocolitis, Hirschsprung's disease, and anal atresia.

Main Results:

  • Twenty-five families (12 SC, 13 PSC) participated in the scar assessment.
  • The purse-string closure (PSC) group demonstrated better scores in scar discoloration, stiffness, thickness, and irregularity, although these differences were not statistically significant.
  • Overall POSAS scores were more favorable in the PSC group, while VAS indicated minimal differences between the techniques.

Conclusions:

  • The purse-string closure (PSC) technique appears to offer advantages in terms of both cosmetic appearance and functional outcome following stoma closure in children.
  • Larger-scale studies are warranted to achieve statistical significance and definitively establish the superiority of PSC over SC.
Abstract

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