Primary closure of stoma site wounds after ostomy takedown.
BACKGROUND
Ostomy reversal is considered a contaminated surgery and, thus, primary closure is believed to increase infection. Various closure techniques have been described and postulated to be superior to primary closure in regards to decreasing stoma site wound infections. The literature has varied in its support for this hypothesis.


METHODS
A retrospective review was performed evaluating several variables including stomal closure method, patient demographics, steroid/immunosuppressant use, chemotherapy or radiation, perioperative antibiotics, and surgical indication to determine whether there was any association with the development of wound infections.


RESULTS
Of 75 patients undergoing ostomy reversal, delayed primary closure/packing/secondary intention was used in 49 (65%), and 26 underwent primary closure (35%). Four patients (5.3%) developed stoma site infections; all had delayed primary closure or packing of their wound (P = .39). No variable was associated significantly with an increased risk of stoma site wound infections.


CONCLUSIONS
Primary closure does not increase the rate of infection.
Harold
Dawn M
DM
Department of Surgery, Madigan Army Medical Center, Fort Lewis, WA, USA.
Johnson
Eric K
EK
Rizzo
Julie A
JA
Steele
Scott R
SR
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003125:Colostomy / Q000009:adverse effects; D062109:Dermatologic Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects; D008297:Male; D010030:Ostomy / Q000009:adverse effects* / Q000379:methods; D011336:Probability; D012086:Reoperation / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D054047:Surgical Stomas / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*
D000900:Anti-Bacterial Agents