Risk factor for the development of surgical site infection following ileostomy reversal: a single-center report

Zhu, Yibin; Chen, Jianxun; Lin, Shuangming; Xu, Dongbo

doi:10.1007/s13304-022-01335-0

Cited by 2 publications

(3 citation statements)

References 35 publications

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“…In our study, p-values for bowel obstruction and perforation were insignificant. This trend, however, has not been consistent, and literature shows that stoma formation in cases of emergency surgery usually has a propensity toward infection upon closure [26][27][28].…”

Section: Discussionmentioning

confidence: 95%

Surgical Site Infection After Stoma Reversal: A Comparison Between Linear and Purse-String Closure

Khan,

Niaz,

Asghar

et al. 2023

Cureus

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Introduction: Intestinal stomas are utilized for both benign and malignant conditions of the intestine to mitigate the risk of anastomotic leakage and re-exploration. However, stomas are associated with various complications, such as stoma necrosis, peri-stomal irritation, parastomal hernia, bleeding, bowel obstruction, and electrolyte abnormalities. Surgical site infection (SSI) is a significant source of morbidity following stoma reversal, leading to increased patient morbidity. The conventional method of stoma reversal involves closing the skin with non-absorbable sutures in a linear fashion, which is known as linear skin closure (LSC). Recently, a new method of skin closure using purse-string approximation (PSA) has been advocated, which allows healing by secondary intention. The rationale for this study is to compare the SSI associated with LSC and PSA after stoma reversal.Objective: This study aims to compare the frequency of SSI between LSC and PSA in stoma reversal.Materials and methods: The study was conducted at the Department of General Surgery, Shifa International Hospitals Ltd. (SIH), Islamabad, Pakistan. The study is a randomized controlled clinical trial carried out between the 14 th of March 2021 and the 22 nd of November 2022. The sampling technique was nonprobability consecutive random sampling. The sample size was calculated using the WHO sample size calculator by using the hypothesis test for two population proportions. The minimum sample size in each group was 40 patients. The total sample size was 80 patients.Results: The overall frequency of SSI in all the patients was 18/80 (22.5%). The frequency of SSI in Group 1 (LSC) was 6/40 (15.0%), and in Group 2 (PSA), it was 12/40 (30.0%). The frequency of SSI in Group 2 (PSA) was twice as high as in Group 1 (LSC); however, the p-value was calculated to be 0.108. Therefore, this difference was statistically insignificant.Conclusions: While PSA has exhibited promise in reducing SSI rates and enhancing aesthetic outcomes and patient satisfaction, there is still enough data favoring LSC. Moreover, insufficient data is available for our population to make a definitive statement. Consequently, further research on this topic is warranted, preferably involving larger sample sizes and multicenter randomized controlled trials, to establish which technique is superior in SSI reduction.

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Section: Discussionmentioning

confidence: 95%

Surgical Site Infection After Stoma Reversal: A Comparison Between Linear and Purse-String Closure

Khan,

Niaz,

Asghar

et al. 2023

Cureus

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“…However, the time to stoma reversal was significantly longer among patients with SSI (median = 560.0 days, IQR = 289.0 to 878.0) compared to those without SSI (median = 281.0 days, IQR = 158.0 to 406.0, p = 0.015) (Table 2) (Figure 1). There is a multitude of studies in the literature with varying reported incidence rates of SSIs after SR. A recent study published in 2022 reported within their cohort of 201 patients that underwent elective ileostomy reversal that 18.4% (n=37) of them developed postoperative SSI (Zhu et al, 2022). Another recent study published in 2021 by Kamada et al, (2021) reported an incidence rate of SSI of 29.1% (n=53) among their cohort of patients that underwent elective SR. Liang et al, (2013) reported that among their cohort of patients that underwent SR that 36% (n=46) developed postoperative SSI.…”

Section: Surgical Site Infection and The Associated Factorsmentioning

confidence: 99%

“…Smoking was not found to be significantly related with a higher number of SSI cases among our cohort, but this could be explained by the limitation of our electronic health record in accurate documentation of patient-related social history and factors. Zhu et al, (2022) reported that among their sample of patients that developed SSI, there was a higher level of preoperative C -reactive protein (CRP) in comparison to the non-SSI group.…”

Section: Surgical Site Infection and The Associated Factorsmentioning

confidence: 99%

"Incidence and risk factors associated with surgical site infection among patients that underwent stoma reversal at a Saudi tertiary hospital"

Alqarni¹,

Almutairi²,

Alshehri³

et al. 2023

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Background: Stoma reversal is used to reconnect the area after a colostomy or ileostomy. There are multiple post-operative complications associated with stoma reversal, most commonly surgical site infection (SSI). Aim: The aim is to determine the incidence rate of SSI in stoma reversal and to assess possible risk factors associated with SSI in stoma reversal patients by analyzing operative and non-operative variables. Methods: This retrospective cohort study was done at the surgery department of king Abdulaziz medical city (KAMC) in Riyadh. All stoma reversal surgeries were either emergent or elective, open or laparoscopic and ileostomy or colostomy. Malignant and benign diseases were included. Results: Out of the 123 patients, 14 developed SSI representing 11.4%. The time to reversal was longer among patients with SSI compared to those without SSI. Significance was related to patients undergoing primary vs. secondary skin closure. Conclusion: There was no significance of the patient's primary disease and comorbidities and development of SSI. However, a longer time period between the stoma creation and stoma reversal and primary skin closure were associated with higher risk of SSI.

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Risk factor for the development of surgical site infection following ileostomy reversal: a single-center report

Cited by 2 publications

References 35 publications

Surgical Site Infection After Stoma Reversal: A Comparison Between Linear and Purse-String Closure

Surgical Site Infection After Stoma Reversal: A Comparison Between Linear and Purse-String Closure

"Incidence and risk factors associated with surgical site infection among patients that underwent stoma reversal at a Saudi tertiary hospital"

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