Randomized clinical trial of short-term outcomes following purse-string versus conventional closure of ileostomy wounds

✍ Scribed by K. Reid; P. Pockney; T. Pollitt; B. Draganic; S. R. Smith

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: English
• Weight: 223 KB
• Volume: 97
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.7151

✦ Synopsis

Abstract

Background

Ileostomy closure is an operation with an underappreciated morbidity, including surgical-site infection, small bowel obstruction and anastomotic leakage. Surgical-site infections, in particular, are a frequent occurrence following closure of contaminated wounds. This randomized controlled trial compared a purse-string closure technique with conventional linear closure.

Methods

Sixty-one patients were randomized to conventional or purse-string closure of ileostomy wounds. The primary endpoint was the incidence of surgical-site infection, including infections requiring hospital or community treatment.

Results

Purse-string closure resulted in fewer surgical-site infections than conventional closure: two of 30 versus 12 of 31 respectively (P = 0·005).

Conclusion

The purse-string method results in a clinically relevant reduction in surgical-site infections after ileostomy closure. Registration number: ACTRN12609000021279 (Australian New Zealand Clinical Trials Registry: http://www.anzctr.org.au/).