Prevalence of Surgical Site Infection at the Stoma Site following Four Skin Closure Techniques: A Retrospective Cohort Study

Li, Linda T.; Brahmbhatt, Reshma; Hicks, Stephanie C.; Davila, Jessica A.; Berger, David H.; Liang, Mike K.

doi:10.1159/000354426

Cited by 29 publications

(20 citation statements)

References 23 publications

(35 reference statements)

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“…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

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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.

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Section: Discussionmentioning

confidence: 82%

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

et al. 2015

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“…One study was excluded due to a sample population which overlapped with a later study . We included the results from our institution's experience for a final sample of 15 studies, representing 2921 individuals in total.…”

Section: Resultsmentioning

confidence: 99%

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

Hicks

Davila

et al. 2014

Colorectal Disease

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“…Moreover, due to long-lasting stoma presence, a higher concentration of skin flora not only at the site of the stoma is observed in this group of patients [23]. Although many strategies and techniques of stoma closure have been proposed, the incidence rate of SSI after stoma reversal is still high and ranged from 2% to 40% [6,[21][22][23][24][25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Effect of closed incision negative pressure wound therapy on incidence rate of surgical site infection after stoma reversal: a pilot study.

Borejsza-Wysocki¹,

Bobkiewicz²,

Francuzik³

et al. 2021

Videosurgery and Other Miniinvasive Techniques

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Introduction:The stoma reversal (SR) procedure is associated with a relatively high risk of perioperative complications with surgical site infection (SSI) as the most common. Recently closed incision negative pressure wound therapy (ciNPWT) was applied widely to prevent SSI. Aim: To investigate the efficiency of ciNPWT in terms of the incidence rate of SSI after SR surgery. Material and methods: As an exploratory observational cohort study patients were treated either with ciNPWT (n = 15) or standard sterile dressing (SSD) (n = 15). CiNPWT was applied every 3 days whereas SSD was changed every day. Clinical evaluation for SSI signs, C-reactive protein level and pain assessment using the visual analogue scale (VAS) were analyzed. Results: The incidence rate of SSI was in 13% (2/15) in the ciNPWT group and 26% (4/15) in the SSD group (p = 0.651, OR = 0.44, 95% CI: 0.03-3.73). All patients in the SSD group who developed SSI presented both local and generalized signs of infection. Pain-VAS levels assessed on the 1 st (MdnciNPWT = 4, MdnSSD = 5, p = 0.027, W = 51.5) and 3 rd postoperative day (MdnciNPWT = 2, MdnSSD = 4, p = 0.014, W = 45.5) were significantly lower in the ciNPWT group than in the SSD group. Conclusions: CiNPWT seems not to have a benefit to reduce SSI after the SR procedure. Further investigation is needed to establish firmly the benefit of using ciNPWT in this group of patients.

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Prevalence of Surgical Site Infection at the Stoma Site following Four Skin Closure Techniques: A Retrospective Cohort Study

Cited by 29 publications

References 23 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

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

Effect of closed incision negative pressure wound therapy on incidence rate of surgical site infection after stoma reversal: a pilot study.

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