title: Association between incisional surgical site infection and the type of skin closure after stoma closure.
abstract: OBJECTIVE
  This study was performed to investigate the effect of subcuticular sutures on the incidence of incisional surgical site infection (SSI) after closure of a diverting stoma.
  
  
  METHODS
  The study was carried out as a retrospective analysis of prospectively collected data from 51 patients who underwent closure of diverting stoma following resections of lower rectal cancer between January 2008 and December 2008. This study attempted to determine whether there was an association between the type of skin closure and the incidence of incisional SSI. Moreover, risk factors for incisional SSI after closure of diverting stoma were identified using a multivariate analysis.
  
  
  RESULTS
  An incisional SSI occurred in 12 of the 51 patients (23.5%). The rate of incisional SSI with subcuticular sutures was 11.1% (3/27) in comparison to 37.5% (9/24) with transdermal suture and skin stapler. A subcuticular skin closure was the only favorable factor that was significantly associated with a lower incidence of incisional SSI (odds ratio: 0.19; 95% confidence interval: 0.04-0.92).
  
  
  CONCLUSIONS
  A subcuticular skin closure has a protective effect against incisional SSI after closure of diverting stoma. A larger study is necessary to further define the role of subcuticular suture on the prevention of incisional SSI in cases of gastrointestinal surgery.
authors: Department of Colorectal and Pelvic Surgery, National Cancer Centre Hospital East, 6-5-1 Kashiwa, Chiba, 277-8577, Japan.
authors: Shin
authors: S
authors: Kobayashi
authors: Masaaki
authors: M
authors: Ito
authors: Masanori
authors: M
authors: Sugito
authors: Akihiro
authors: A
authors: Kobayashi
authors: Yusuke
authors: Y
authors: Nishizawa
authors: Norio
authors: N
authors: Saito
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D054047:Surgical Stomas / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000209:etiology*; D058106:Wound Closure Techniques / Q000009:adverse effects*