Clinical trial on the incidence of wound infection and patient satisfaction after stoma closure: comparison of two skin closure techniques.
OBJECTIVE
Surgical site infection (SSI) is one of the most common complications that can occur after stoma closure. Reports have described differences in the incidence of wound infection depending on the skin closure technique, but there is no consensus on the ideal closure technique for a stoma wound. The aim of this study was to compare the incidence of SSI and the patient satisfaction between a circumferential purse-string approximation (CPA) and a primary linear closure (PC) of a stoma wound.


METHODS
This prospective nonrandomized trial enrolled 48 patients who underwent a stoma closure from February 2010 to October 2013. Patients were divided into two groups according to the stoma closing technique: the CPA group (n = 34) and the PC group (n = 14). The incidences of SSI for the two groups were compared, and the patients' satisfaction with the stoma closure was determined by using a questionnaire.


RESULTS
SSI occurred in 3 of 48 patients (6.3%) and was more frequent in the PC group than in the CPA group (3/14 [21.4%] vs. 0/34 [0%], P = 0.021). Time to complete healing after stoma closure in the CPA group was 32 days (range, 14-61 days). Patients in the CPA group were more satisfied with the resulting wound scar (P = 0.043).


CONCLUSIONS
After stoma closure, CPA was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to PC. However, with the CPA technique, the time to heal is longer than it is with PC.
Department of Surgery, Dankook University College of Medicine, Cheonan, Korea.
Sang Il
SI
Yoon
Department of Surgery, Dankook University College of Medicine, Cheonan, Korea.
Sun Mi
SM
Bae
Department of Surgery, Dankook University College of Medicine, Cheonan, Korea.
Hwan
H
Namgung
Department of Surgery, Dankook University College of Medicine, Cheonan, Korea.
Dong Guk
DG
Park
Patient satisfaction; Surgical stomas; Wound closure technique; Wound infection