title: A beneficial effect of purse-string skin closure after ileostomy takedown: a retrospective cohort study.
abstract: OBJECTIVE
  The aim of this study was to investigate the clinical benefits of purse-string skin closure (PS) in daily practice compared with conventional linear skin closure (CL) after ileostomy takedown in Korean population.
  
  
  METHODS
  These retrospectively collected data were based on 157 consecutive patients who underwent ileostomy takedown between November 2010 and September 2011. Before March, 2011, CL was performed in 79 patients. Thereafter, PS was performed in 78 patients. The medical records including pain score recorded daily were reviewed and the postoperative outcomes, including SSI, were analyzed.
  
  
  RESULTS
  PS group had a significantly lower overall complication rate than the CL group (8.97% vs. 25.32%, p = 0.010). Among complications, PS group had a significantly lower SSI rate than the CL group (0% vs. 11.39%, p = 0.003). After adjusted for other risk factors (smoking, body mass index, anastomosis method), PS method was associated significantly and independently with a lower SSI rate than CL method (adjusted odds ratio: 26.63, 95% confidence interval: 3.02-267.70, p = 0.001). And the two groups did not differ in terms of postoperative pain (p = 0.323) or pain pattern (p = 0.548).
  
  
  CONCLUSIONS
  In daily practice, PS had a beneficial effect on SSI in patients who underwent ileostomy takedown in the Korean population.
authors.affiliation: Department of Surgery, Seoul National University Hospital and College of Medicine, Seoul, Republic of Korea.
authors.forename: Yong Joon
authors.initials: YJ
authors.lastname: Suh
authors.affiliation: Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Republic of Korea. Electronic address: sowisdom@gmail.com.
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Park
authors.affiliation: Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Republic of Korea.
authors.forename: Yong Sok
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Republic of Korea.
authors.forename: Sung Chan
authors.initials: SC
authors.lastname: Park
authors.affiliation: Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Republic of Korea.
authors.forename: Jae Hwan
authors.initials: JH
authors.lastname: Oh
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: Abdominal wound closure techniques; Ileostomy; Surgical wound infection