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


CONCLUSIONS
The purse-string method results in a clinically relevant reduction in surgical-site infections after ileostomy closure.


BACKGROUND
ACTRN12609000021279 (Australian New Zealand Clinical Trials Registry: http://www.anzctr.org.au/).
Reid
K
K
Department of Colorectal Surgery, John Hunter Hospital, New South Wales, Australia.
Pockney
P
P
Pollitt
T
T
Draganic
B
B
Smith
S R
SR
D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D013530:Surgical Wound Infection / Q000209:etiology; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology