Clinical trial on the incidence of wound infection and patient satisfaction after stoma closure: comparison of two skin closure techniques

Sang Il Yoon, Sun Mi Bae, Hwan Namgung, Dong Guk Park, Sang Il Yoon, Sun Mi Bae, Hwan Namgung, Dong Guk Park

Abstract

Purpose: Surgical site infection (SSI) is one of the most common complications that can occur after stoma closure. Reports have described differences in the incidence of wound infection depending on the skin closure technique, but there is no consensus on the ideal closure technique for a stoma wound. The aim of this study was to compare the incidence of SSI and the patient satisfaction between a circumferential purse-string approximation (CPA) and a primary linear closure (PC) of a stoma wound.

Methods: This prospective nonrandomized trial enrolled 48 patients who underwent a stoma closure from February 2010 to October 2013. Patients were divided into two groups according to the stoma closing technique: the CPA group (n = 34) and the PC group (n = 14). The incidences of SSI for the two groups were compared, and the patients' satisfaction with the stoma closure was determined by using a questionnaire.

Results: SSI occurred in 3 of 48 patients (6.3%) and was more frequent in the PC group than in the CPA group (3/14 [21.4%] vs. 0/34 [0%], P = 0.021). Time to complete healing after stoma closure in the CPA group was 32 days (range, 14-61 days). Patients in the CPA group were more satisfied with the resulting wound scar (P = 0.043).

Conclusion: After stoma closure, CPA was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to PC. However, with the CPA technique, the time to heal is longer than it is with PC.

Keywords: Patient satisfaction; Surgical stomas; Wound closure technique; Wound infection.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1. (A) Primary linear closure wound…
Fig. 1. (A) Primary linear closure wound on postoperative day 2 in a 73-year-old male patient. (B) Appearance of a scar after complete wound healing.
Fig. 2. (A) Circumferential purse-string approximation wound…
Fig. 2. (A) Circumferential purse-string approximation wound on postoperative day 2 in a 55-year-old male patient. (B) Appearance of a scar after complete wound healing. (C) Illustration showing the operative procedure for the circumferential purse-string approximation.
Fig. 3. Satisfactions scores for the wounds.…
Fig. 3. Satisfactions scores for the wounds. CPA, circumferential purse-string approximation; PC, primary linear closure.

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