Factors predicting stomal wound closure infection rates.

Area of Science:

• Surgical outcomes
• Wound healing
• Infectious disease

Background:

• Stoma closure procedures often result in high rates of surgical site infections.
• Identifying risk factors is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate risk factors associated with wound infection after stoma closure.
• To assess the impact of different stoma wound closure techniques on infection rates.

Main Methods:

• Retrospective analysis of 142 patients undergoing ileostomy or colostomy closure.
• Comparison of infection rates across three closure techniques: primary closure (PC), primary closure with Penrose drain (PCP), and purse-string circumferential wound approximation (PSC).
• Analysis of patient factors including age, sex, ASA score, obesity, smoking, and antibiotic prophylaxis.

Main Results:

• Overall wound infection rate was 10.7%.
• Purse-string circumferential wound approximation (PSC) technique showed significantly lower infection rates (3.6%) compared to primary closure (PC) (17.9%) and primary closure with Penrose drain (PCP) (10.5%).
• Obesity (p = 0.024) was a significant risk factor, while prophylactic triple-agent antibiotics (p = 0.012) demonstrated a protective effect.

Conclusions:

• The purse-string circumferential wound approximation (PSC) technique is recommended over primary closure (PC) or primary closure with Penrose drain (PCP) to minimize stomal wound infections.
• Addressing patient obesity and utilizing prophylactic triple antibiotics are key strategies to reduce infection rates.