Back to Search Start Over

Single‐centre experience of loop ileostomy closure: a retrospective comparison of conventional‐linear closure and purse‐string closure on surgical‐site‐infection rates

Authors :
Munyaradzi G. Nyandoro
Yi Th'ng Seow
Joel Stein
Mary Theophilus
Source :
ANZ Journal of Surgery. 93:629-635
Publication Year :
2022
Publisher :
Wiley, 2022.

Abstract

The closure of ileostomy is associated with significant morbidity, the most common being surgical site infection (SSI), ranging up to 41%. This study compared the stoma site SSI rates after either the conventional-linear closure (CLC) or purse-string closure (PSC).The study conducted a single-centre retrospective cohort study of elective loop-ileostomy closures from June 2015 to January 2021. Patient demographics, surgical techniques and outcomes, including SSI rates, were analysed using SPSS ver.27.Hundred and six patients underwent loop-ileostomy closure, 91.5% (n = 97) had CLC of which 67% (n = 65) were stapled. Male patients comprise 67.9%, with a median age of 62. The median BMI was 27. The median surgical time, LOS and interval time to closure were 66 min, 4.5 days and 5.5 months, respectively. The SSI rate was 19.6% (n = 19) for CLC and 11.1% (n = 1) for PSC. The SSI rate was significantly reduced to 3.7% (P 0.001) in CLC when the site was washed with betadine. Multivariate logistic regression controlled for statistically insignificant confounders showed that stoma site betadine wash was significantly and independently associated with reduced SSI risk (P = 0.026). Other significant factors which reduced SSI risk were prophylactic antibiotic therapy (P = 0.004), operative time 60 min (P = 0.021), and having the closure done3 months post the formation surgery (P = 0.040).This study found that stoma SSI risk was independently and significantly reduced when CLC stapled site was washed with betadine. This low-cost intervention that significantly reduced skin closure site SSI rates is readily available and can easily be adopted into clinical practice.

Subjects

Subjects :
Surgery
General Medicine

Details

ISSN :
14452197 and 14451433
Volume :
93
Database :
OpenAIRE
Journal :
ANZ Journal of Surgery
Accession number :
edsair.doi.dedup.....0281cc41dde91b2379f14010acacad15
Full Text :
https://doi.org/10.1111/ans.18083