title: Primary closure of the skin after stoma closure. Management of wound infections is easy without (long-term) complications.
abstract: OBJECTIVE
  Whether or not the skin can be closed primarily after stoma closure is still debated in the existing literature. Therefore, this present study was undertaken to compare the complications and consequences between primary or delayed closure of the skin after stoma closure.
  
  
  METHODS
  All consecutive stoma closures between January 2001 and August 2004 were included. In 25 patients (group I), the skin at the stoma site was closed primarily. In 37 patients (group II), the skin was left open. Patient characteristics, comorbidity, medication use, hospital stay and long-term complications were recorded and retrospectively compared between the two groups.
  
  
  RESULTS
  In group I, wound infection rate was 36% versus 5% in group II (p = 0.005). Infected wounds were mostly found after ileostomy closure with primary closure of the skin (p = 0.018). The occurrence of a wound infection was not related to the use of corticosteroids, diabetes mellitus, fistula formation, anastomotic leakage, or primary disease and did not lead to a prolonged hospital stay or an increased number of incisional hernias. conclusion: In our opinion, it is safe to close the skin after stoma closure, but patients should be informed carefully about the advantages and disadvantages of this strategy, especially in case of ileostomy closure.
authors.affiliation: Department of Surgery, Medisch Centrum Rijnmond Zuid, NL-3078 HT Rotterdam, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Vermulst
authors.forename: J
authors.initials: J
authors.lastname: Vermeulen
authors.forename: E J
authors.initials: EJ
authors.lastname: Hazebroek
authors.forename: P P L O
authors.initials: PP
authors.lastname: Coene
authors.forename: E
authors.initials: E
authors.lastname: van der Harst
mesh_terms: D000368:Aged; D003125:Colostomy; D062109:Dermatologic Surgical Procedures; D005260:Female; D006801:Humans; D007081:Ileostomy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology