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Comparison of purse-string technique vs linear suture for skin closure after ileostomy reversal. A randomized controlled trial

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Abstract

Background

Protective stoma after rectal surgery has been associated with important complications. The most common is surgical site infection (SSI) high rates after stoma reversal reported in literature. Our study compared the rate of SSI of two skin closure techniques, linear closure, and purse string closure.

Methods

We carried out a single center, prospective, randomized controlled trial in the Department of Colorectal Surgery of Fondazione Policlinico Campus Bio-Medico of Rome between January 2018 through December 2021, to compare LC vs PS closure of ileostomy sites.

Results

A total of 117 patients (53.84% male) with a mean age of 65.68 ± 14.33 years were finally evaluated in the study. 58 patients were included in the PS group and 59 patients in the LC one.

There was a marked difference in the SSI rate between the two arms of the study: 3 of 58 patients in the purse-string arm versus 11 of 59 in the control arm (p = 0.043).

The outcome of cosmesis was also higher in PS, with a statistical significance (mean ± DS 4,01 ± 0,73 for PS group vs mean ± DS 2,38 ± 0,72 for LC group, p < 0,001).

Conclusion

Our study demonstrated that the PS technique had a significantly lower incidence of stoma site SSI compared with LC technique. Our findings are in line with other randomized studies and suggest that PS closure could be considered as standard of care for wound closure after ileostomy reversal.

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Data availability

No datasets were generated or analysed during the current study.

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Authors and Affiliations

  1. Colorectal Surgery Clinical and Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico Di Roma, University Campus Bio-Medico, Via Àlvaro del Portillo 200, 00128, Rome, Italy

    Filippo Carannante, Gianluca Costa, Valentina Miacci, Gianfranco Bianco, Gianluca Masciana, Marco Caricato & Gabriella Teresa Capolupo

  2. Università Campus Bio-Medico Di Roma, Via Àlvaro del Portillo 200, 00128, Rome, Italy

    Filippo Carannante, Valentina Miacci, Gianfranco Bianco, Marco Caricato & Gabriella Teresa Capolupo

  3. Tumori Ereditari Dell’Apparato Digerente, Chirurgia Generale Oncologica 2 - Colon-Retto, Fondazione IRCCS Istituto Nazionale Dei Tumori, Via Venezian 1, 20133, Milano, Italy

    Sara Lauricella

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  1. Filippo Carannante
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  2. Gianluca Costa
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  6. Sara Lauricella
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Contributions

FC, GC, VM and GTC: study conception and design, acquisition of data, analysis, and interpretation of data, writing manuscript. SL, GM, VM and GB: acquisition of data and analysis. GC: analysis and interpretation of data, proof reading. FC, GC and MC: review and proof reading.

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Correspondence to Filippo Carannante.

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The authors declare no competing interests.

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Carannante, F., Costa, G., Miacci, V. et al. Comparison of purse-string technique vs linear suture for skin closure after ileostomy reversal. A randomized controlled trial. Langenbecks Arch Surg 409, 141 (2024). https://doi.org/10.1007/s00423-024-03332-w

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