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A combination of subcuticular sutures and subcutaneous closed-suction drainage reduces the risk of incisional surgical site infection in loop ileostomy closure

Surgery Today volume 51, pages 605–611 (2021)Cite this article

Abstract

Purpose

The purpose of this study was to evaluate the effectiveness of a wound closure method using a combination of subcuticular sutures and subcutaneous closed-suction drainage (SS closure) for preventing incisional surgical site infection (SSI) in loop ileostomy closure.

Methods

A total of 178 consecutive patients who underwent loop ileostomy closure at Nara Medical University Hospital between 2004 and 2018 were retrospectively assessed. The patients were divided into 2 groups: the conventional skin closure (CC) group from 2004 to 2009 (75 patients) and the SS closure (SS) group from 2010 to 2018 (103 patients). The incidence of incisional SSI was compared between the two groups, and the factors associated with incisional SSI were examined by univariate and multivariate analyses.

Results

Incisional SSI occurred in 7 cases (9.3%) in the CC group but was significantly reduced to only 1 case (0.9%) in the SS group (p = 0.034). In the univariate analysis, the hemoglobin levels, serum creatinine levels, and SS closure were associated with incisional SSI. SS closure was the only independent preventive factor for incisional SSI according to the multivariate analysis (hazard ratio = 0.24, p = 0.011).

Conclusion

The combination of subcuticular sutures and subcutaneous closed-suction drainage may be a promising way of preventing incisional SSI in loop ileostomy closure.

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Affiliations

  1. Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan

    Kohei Fukuoka, Fumikazu Koyama, Hiroyuki Kuge, Shinsaku Obara, Takayuki Nakamoto, Yosuke Iwasa, Takeshi Takei, Yayoi Matsumoto, Tomomi Sadamitsu & Masayuki Sho

  2. Division of Endoscopy, Nara Medical University Hospital, 840 Shijo-cho, Kashihara, 634-8522, Nara, Japan

    Fumikazu Koyama & Takayuki Nakamoto

Authors
  1. Kohei Fukuoka
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  2. Fumikazu Koyama
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  3. Hiroyuki Kuge
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  4. Shinsaku Obara
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  5. Takayuki Nakamoto
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  6. Yosuke Iwasa
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  7. Takeshi Takei
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  9. Tomomi Sadamitsu
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Corresponding author

Correspondence to Fumikazu Koyama.

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Conflict of interest

Kohei Fukuoka and the other co-authors have no conflicts of interest.

Ethical statements

The protocol for the research project was approved by the Ethics Committee of the institution (No. 2372), and it conforms to the provisions of the Declaration of Helsinki.

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Fukuoka, K., Koyama, F., Kuge, H. et al. A combination of subcuticular sutures and subcutaneous closed-suction drainage reduces the risk of incisional surgical site infection in loop ileostomy closure. Surg Today 51, 605–611 (2021). https://doi.org/10.1007/s00595-020-02128-x

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  • DOI: https://doi.org/10.1007/s00595-020-02128-x

Keywords

  • Loop ileostomy closure
  • Subcuticular suture
  • Closed-suction drainage
  • Surgical site infection