Department of General, Visceral and Transplant Surgery, RWTH Aachen University Hospital, Germany.
Int J Surg. 2013;11(10):1123-5. doi: 10.1016/j.ijsu.2013.09.003. Epub 2013 Sep 12.
Intestinal stoma closure is associated with high risk of surgical site infection (SSI) at stoma reversal site. The aim of this retrospective cohort study was to determine the outcome of purse string approximation (PSA) compared to primary linear closure (PLC) of the skin after loop ileostomy reversal.
Data of 140 patients operated between 2005 and 2012 were analyzed in this two-center-study to determine the outcome of patients with either PSA (n = 44) or PLC (n = 96) after loop ileostomy reversal.
Patients in the PSA group were significantly older than in the PLC group (64 ± 15 vs. 57 ± 18; p = 0.026). Cardiac diseases were significantly more present in the PSA group in comparison to the PLC group (59% vs. 38%; p = 0.017). Stoma creation was significantly more often due to malignancy in the PSA group in comparison to the PLC group (68% vs. 50%; p = 0.044). SSI occurred significantly more often in the PLC group in comparison to the PSA group (17% vs. 5%; p = 0.047).
The risk for SSI is lower in patients with PSA in comparison to patients with PLC. In order to diminish SSI we recommend performing a PSA in patients with loop ileostomy reversal.
肠造口关闭与造口反转部位手术部位感染（SSI）的风险较高有关。本回顾性队列研究的目的是确定荷包缝合（PSA）与回肠造口反转后皮肤的线性一期缝合（PLC）的结果。
对 2005 年至 2012 年间进行手术的 140 例患者的数据进行了这项双中心研究，以确定行回肠造口反转后行 PSA（n = 44）或 PLC（n = 96）的患者的结局。
PSA 组患者明显比 PLC 组患者年龄大（64 ± 15 岁 vs. 57 ± 18 岁；p = 0.026）。与 PLC 组相比，PSA 组患者的心脏病明显更多（59% vs. 38%；p = 0.017）。与 PLC 组相比，PSA 组患者造口形成更多是由于恶性肿瘤（68% vs. 50%；p = 0.044）。与 PSA 组相比，PLC 组 SSI 的发生率明显更高（17% vs. 5%；p = 0.047）。
与 PLC 组相比，PSA 组患者 SSI 的风险较低。为了降低 SSI 的风险，我们建议在进行回肠造口反转时行 PSA。
