title: `Canoe closure' of loop ileostomy gives improved cosmesis compared with conventional closure.
abstract: OBJECTIVE
  The cosmetic appearance of the abdominal scar following closure of loop ileostomy can result in puckering and tethering of the skin, together with a shallow depression. A technique to improve the cosmetic result which also facilitates an easier and more secure closure is described.
  
  
  METHODS
  A measured elliptical incision, five times greater in length than the ileostomy diameter, is marked. The skin ellipse, subcutaneous fat and ileo- stomy are mobilized together. The skin is removed and the ileostomy is closed with a stapler. This technique is compared with conventional techniques with regard to operative stay, complications and cosmetic appearance over an 18-month period.
  
  
  RESULTS
  The median operating time has been 50 min and post-operative stay 5 days. There have been no major complications.
  
  
  CONCLUSIONS
  This technique allows better access, improves on cosmesis and has a low complication rate.
authors.affiliation: Department of Surgery, The Good Hope Hospital NHS Trust, Sutton Coldfield, UK.
authors.lastname: Patel
authors.lastname: Frost
authors.lastname: Bearn
authors.lastname: Allan