Yoshimatsu Kazuhiko, Sagawa Masano, Yokomizo Hajime, Yano Yuki, Okayama Sachiyo, Satake Masaya, Yamada Yasufumi, Matsumoto Atsuo, Shiozawa Shunichi, Shimakawa Takeshi, Katsube Takao, Naritaka Yoshihiko
Department of Surgery, Tokyo Women's Medical University, Medical Center East.
J Nippon Med Sch. 2018;85(3):183-186. doi: 10.1272/jnms.JNMS.2018_85-27.
Incisional surgical site infection (SSI) is a leading complication of stoma reversal procedures. This retrospective study was conducted to assess the incidence of incisional SSI and other wound complications when wound closure was achieved by subcuticular suturing and closed suction drainage following stoma reversal. We analyzed data from a total of 49 patients, all of whom had undergone insertion of a 10 Fr closed suction drainage tube in the fascia, following irrigation with approximately 300 mL of physiological saline. We then performed subcuticular suturing with 4-0 monofilament absorbable sutures. The median age of our patient population (34 men and 15 women) was 68 (range, 35-84) years. Six patients had an end stoma and 43 had a loop stoma. The wound category was 'contaminated' in 18 patients, while an incisional SSI was observed in one patient (2.0%). No wound disruptions, seromas, or drain infections were evident. Our data are reliable, but our study is limited in terms of general applicability; however, the low SSI rate indicates that the procedure is acceptable. Further research into this procedure will require a randomized trial design.
切口手术部位感染(SSI)是造口回纳手术的主要并发症。本回顾性研究旨在评估造口回纳后采用皮下缝合和封闭负压引流实现伤口闭合时切口SSI及其他伤口并发症的发生率。我们分析了总共49例患者的数据,所有患者在使用约300 mL生理盐水冲洗后,均在筋膜内插入了一根10 Fr的封闭负压引流管。然后我们用4-0单丝可吸收缝线进行皮下缝合。我们的患者群体(34名男性和15名女性)的中位年龄为68岁(范围35-84岁)。6例患者为端式造口,43例为袢式造口。18例患者的伤口类别为“污染”,1例患者(2.0%)发生了切口SSI。未发现伤口裂开、血清肿或引流管感染。我们的数据可靠,但我们的研究在普遍适用性方面存在局限性;然而,低SSI率表明该手术是可接受的。对此手术的进一步研究将需要采用随机试验设计。