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

Détails

ID Serval
serval:BIB_D8790ED34356
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Wound infection following stoma takedown: primary skin closure versus subcuticular purse-string suture.
Périodique
World Journal of Surgery
Auteur(s)
Marquez T.T., Christoforidis D., Abraham A., Madoff R.D., Rothenberger D.A.
ISSN
1432-2323[electronic], 0364-2313[linking]
Statut éditorial
Publié
Date de publication
2010
Volume
34
Numéro
12
Pages
2877-2882
Langue
anglais
Résumé
Abstract: Background Stoma closure has been associated with a high rate of surgical site infection (SSI) and the ideal stoma-site skin closure technique is still debated. The aim of this study was to compare the rate of SSI following primary skin closure (PC) versus a skin-approximating, subcuticular purse-string closure (APS).
Methods All consecutive patients undergoing stoma closure between 2002 and 2007 by two surgeons at a single tertiary-care institution were retrospectively assessed. Patients who had a new stoma created at the same site or those without wound closure were excluded. The end point was SSI, determined according to current CDC guidelines, at the stoma closure site and/or the midline laparotomy incision.
Results There were 61 patients in the PC group (surgeon A: 58 of 61) and 17 in the APS group (surgeon B: 16 of 17). The two groups were similar in baseline and intraoperative characteristics, except that patients in the PC group were more often diagnosed with benign disease (p = 0.0156) and more often had a stapled anastomosis (p = 0.002). The overall SSI rate was 14 of 78 (18%). All SSIs occurred in the PC group (14 of 61 vs. 0 of 17, p = 0.03).
Conclusions Our study suggests that a skin-approximating closure with a subcuticular purse-string of the stoma site leads to less SSI than a primary closure. Randomized studies are needed to confirm our findings and assess additional end points such as healing time, cost, and patient satisfaction.
Pubmed
Web of science
Création de la notice
14/12/2010 10:18
Dernière modification de la notice
03/03/2018 21:51
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