Purse-String Versus Linear Conventional Skin Wound Closure of an Ileostomy: A Randomized Clinical Trial.
OBJECTIVE
Infection is one of the most frequent complications that can occur after ileostomy closure. The incidence of wound infection depends on the skin closure technique, but there is no agreement on the perfect closure method for an ileostomy wound. The aim of this study was to evaluate the incidence of infection, the patient's approval, and the patient's pain between purse-string closure (PSC) and the usual linear closure (LC) of a stoma wound.


METHODS
This randomized clinical trial enrolled 66 patients who underwent a stoma closure from February 2015 to May 2015 in Sari Emam Khomeini Hospital. Patients were divided into 2 groups according to the stoma closing method: the PSC group (n = 34) and the LC group (n = 32). The incidences of infection for the 2 groups were compared, and the patients' satisfaction and pain with the stoma were determined by using a questionnaire.


RESULTS
Infection occurred in 1 of 34 PSC patients (2.9%) and in 7 of 32 LC patients (21.8%), and this difference was statistically significant (P = 0.021). Patients in the PSC group were more satisfied with the resulting wound scar and its cosmetic appearance at one month and three months after surgery (P = 0.043).


CONCLUSIONS
After stoma closure, PSC was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to LC. However, the healing period for patients who underwent PSC was longer than it was for those who underwent LC.
Department of Colorectal Surgery, Mazandaran University of Medical Sciences, Sari, Iran.
Mina
M
Alvandipour
Department of General Surgery, Mazandaran University of Medical Sciences, Sari, Iran.
Babak
B
Gharedaghi
Department of Emergency Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Hamed
H
Khodabakhsh
Student Research Committee, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Mohammad Yasin
MY
Karami
Closure; Ileostomy; Infection; Patient satisfaction; Surgical stoma