Circular closure is associated with the lowest rate of surgical site infection following stoma reversal: a systematic review and multiple treatment meta‐analysis

Li, L. T.; Hicks, Stephanie C.; Davila, Jessica A.; Kao, Lillian S.; Berger, Rachel L.; Arita, Nestor A.; Liang, Mike K.

doi:10.1111/codi.12556

Cited by 30 publications

(30 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, in order to improve patient outcomes and make EC even more cost effective, efforts should be taken to reduce wound infection. Several studies evaluating methods of skin closure after ileostomy reversal have found purse-string closure to be associated with the fewest postoperative wound infections [30,31,32]. Neither this study nor the RCT mentioned any standardised method of skin closure following reversal.…”

Section: Discussionmentioning

confidence: 82%

Cost Analysis of Early versus Delayed Loop Ileostomy Closure: A Case-Matched Study

et al. 2015

View full text Add to dashboard Cite

Background/Aims: The optimal timing for the closure of loop ileostomies remains controversial. The aim of the current study was to investigate whether early ileostomy closure (EC) (<2 weeks post-formation) results in significant healthcare savings as against late closure (LC). Methods: Patients with available cost data that underwent EC between January 2008 and December 2012 were compared against matched patients undergoing LC during the same period. Direct hospital costs for the two groups were compared. Results: There were 42 EC patients and 61 LC patients. EC patients had significantly less ileostomy-related complications (p < 0.001) and hospital readmissions (p < 0.001). Operative time (p < 0.001) and operative cost (p = 0.002) were also both significantly less in the EC group. Community nursing costs favoured the LC group (p = 0.047). The EC group had an increased post-closure wound infection rate (p = 0.02). The mean total direct cost per patient was NZD 13,724 (SD NZD 3,736) for EC and NZD 16,728 (SD NZD 8,028) for LC. Representing an average costs saving of NZD 3,004 per patient favouring EC (p = 0.012). Conclusion: Although EC increases the post-closure wound infection rate, EC reduces ileostomy complications, hospital readmissions and operative costs resulting in significant healthcare savings. In order to improve patient outcomes and make EC even more cost effective, efforts should be taken to reduce wound infections.

show abstract

Section: Discussionmentioning

confidence: 82%

Cost Analysis of Early versus Delayed Loop Ileostomy Closure: A Case-Matched Study

et al. 2015

View full text Add to dashboard Cite

show abstract

“…the study sample size had been estimated at 118 patients, yet only 61 were enrolled, and the trial was halted early because of an overwhelming number of ssis in the CP group. 29,30 the rate of delayed healing (defined as an open wound requiring a dressing for >30 days) was similar in both groups. 13 Camacho-mauries et al 19 randomly assigned 61 patients with ileostomies or colostomies to Ps or CP closure.…”

Section: Discussionmentioning

confidence: 85%

“…5-10 one of the most common complications after stoma reversal is surgical site infection (ssi) with rates in the literature varying from 0% to 40%. 29,30 We previously performed a retrospective study comparing CP with Ps closure and found a higher incidence of ssi with CP closure. 15,[21][22][23][24][25][26][27][28] the optimal wound closure technique after stoma reversal has been widely debated.…”

mentioning

confidence: 99%

Pursestring Closure of the Stoma Site Leads to Fewer Wound Infections

Lee

Marquez

Clerc

et al. 2014

Diseases of the Colon &Amp; Rectum

View full text Add to dashboard Cite

show abstract

“…Several studies have reported a 40% incidence in incisional SSI, a complication which increases medical costs and prolongs a patient's hospital stay 1,2,4 . A prospective randomized study and meta-analysis found that delayed primary closure decreased the rate of wound infection more readily than conventional primary closure 5,6 . However, the optimal timing of wound closure following stoma takedown has yet to be determined.…”

Section: Introductionmentioning

confidence: 99%

Subcuticular Suturing with Closed Suction Drainage for Wound Closure Following Stoma Reversal

et al. 2018

View full text Add to dashboard Cite

Incisional surgical site infection (SSI) is a leading complication of stoma reversal procedures. This retrospective study was conducted to assess the incidence of incisional SSI and other wound complications when wound closure was achieved by subcuticular suturing and closed suction drainage following stoma reversal. We analyzed data from a total of 49 patients, all of whom had undergone insertion of a 10 Fr closed suction drainage tube in the fascia, following irrigation with approximately 300 mL of physiological saline. We then performed subcuticular suturing with 4-0 monofilament absorbable sutures. The median age of our patient population (34 men and 15 women) was 68 (range, 35-84) years. Six patients had an end stoma and 43 had a loop stoma. The wound category was 'contaminated' in 18 patients, while an incisional SSI was observed in one patient (2.0%). No wound disruptions, seromas, or drain infections were evident. Our data are reliable, but our study is limited in terms of general applicability; however, the low SSI rate indicates that the procedure is acceptable. Further research into this procedure will require a randomized trial design.

show abstract

Circular closure is associated with the lowest rate of surgical site infection following stoma reversal: a systematic review and multiple treatment meta‐analysis

Abstract: This study showed that circular closure is the best skin closure technique after stoma reversal in terms of SSI rate, but the quality of supporting evidence is limited, precluding definite conclusions.

Cited by 30 publications

References 35 publications

Cost Analysis of Early versus Delayed Loop Ileostomy Closure: A Case-Matched Study

Cost Analysis of Early versus Delayed Loop Ileostomy Closure: A Case-Matched Study

Pursestring Closure of the Stoma Site Leads to Fewer Wound Infections

Subcuticular Suturing with Closed Suction Drainage for Wound Closure Following Stoma Reversal

Contact Info

Product

Resources

About