Delayed Primary Skin Closure Followed by Single-use Negative-pressure Wound Therapy Is Optimal for Wound Management...

Although the purse-string suture (PSS) method is widely adopted to reduce surgical-site infection (SSI; the commonest complication following bowel-stoma closure), this technique is associated with delayed epithelialization. Recently, delayed primary closure (DPC) combined with negative-pressure wound therapy (NPWT) has been proposed as a promising alternative. This study aimed to evaluate the clinical efficacy of DPC with NPWT compared to the PSS method in stoma-closure surgery.

We conducted a retrospective observational study involving 31 patients who underwent stoma closure between January 2021 and March 2023. Patients were categorized into two groups: PSS with or without NPWT (PSS±NPWT; n=15) and DPC with NPWT (DPC+NPWT; n=16). The primary outcome was wound-healing duration; the secondary outcomes were patient satisfaction and in-hospital costs.

The wound-healing duration was significantly shorter in the DPC+NPWT group compared to the PSS±NPWT group (median: 20 vs. 45 days, p<0.001). Multivariate analysis identified wound-closure method as an independent predictor of wound healing at 30 days. Patient-reported outcomes indicated improved wound-care experience and a trend toward better cosmetic satisfaction in the DPC+NPWT group. Although not statistically significant, the total in-hospital costs were lower in the DPC+NPWT group despite higher device-related expenditures.

DPC with NPWT significantly shortened the wound-healing duration and showed potential benefits regarding patient satisfaction and healthcare costs compared to the PSS method. These findings suggest DPC with NPWT as a viable alternative for bowel-stoma closure and wound management.