Comparing Surgical Site Infection Rate Between Primary Closure and Rhomboid Flap After Stoma Reversal.

Area of Science:

• Surgical Innovation
• Wound Healing
• Infectious Disease Prevention

Background:

• Primary closure (PC) after stoma reversal is linked to high surgical site infection (SSI) rates.
• A novel rhomboid flap (RF) technique was developed for skin closure post-stoma reversal.
• This study compares SSI rates between RF and PC methods.

Purpose of the Study:

• To evaluate the efficacy of the rhomboid flap (RF) technique in reducing surgical site infections (SSIs) after stoma reversal.
• To compare the SSI rates between RF and primary closure (PC) methods.
• To analyze SSI rates specifically for colostomy and ileostomy reversals.

Main Methods:

• A single-center retrospective study involving 154 patients (33 RF, 121 PC) undergoing stoma reversal.
• Data collected via retrospective review of medical records from April 2019 to July 2022.
• Wound infection assessed at 1-month follow-up based on standard clinical and microbiological criteria.

Main Results:

• Overall SSI rate was 12.1% for RF versus 25.6% for PC (P=0.158).
• A significant reduction in SSI was observed in the RF group for colostomy reversals (11.1% vs. 36.9%, P=0.045).
• No significant difference in SSI rates was found for ileostomy reversals between the two techniques (13.3% vs. 12.5%, P=1.000).

Conclusions:

• The rhomboid flap (RF) technique may significantly decrease SSI rates following colostomy reversal by addressing inflammatory tissues and dead space.
• While RF may require a slightly longer operative time, its potential to reduce infections is notable.
• Further investigation is warranted to validate RF efficacy, compare it with other closure methods, and assess long-term complications.