Outcomes of Purse-string versus Conventional Linear Suture Closure of the Skin Wound Following Ileostomy Reversal

Abstract

Objective: Intestinal stomas are made in a variety of settings and their reversal is also a routine surgery. Due to their clean contaminated nature, there is a high risk of surgical site infection post-operatively. The objective of this study is to determine the difference in outcomes in two different techniques of skin closure after stoma reversal

Methods: The study was conducted at department of general surgery, Pakistan Institute of Medical Sciences, Islamabad over a period of six months. Seventy-one patients who underwent ileostomy reversal surgery in an elective setting were assigned two groups randomly: 34 in Group A and 37 in Group B. The group A patients underwent purse string closure for stoma site skin wound whereas patients in group B underwent conventional linear closure. Time taken for surgery was noted and the patients were followed over one month period for development of any surgical site infection or dog-ear deformity.

Results: The incidence of surgical site infection was 8.8% in the purse string closure group compared to 43.2 % in the linear closure group. Seven patients in group B developed dog ear deformity whereas no such case was noted in Group A.

Conclusions: Purse string closure is an effective and applicable technique for the closure of skin wounds after stoma reversal surgery. It is comparatively better in terms of prevention of surgical site infection as well as dog ear deformity in the closure of skin wounds after ileostomy reversal.

Key words: Purse string suture, linear suture, ileostomy reversal, intestinal stoma, surgical site infection, dog ear deformity.