Gao Yu-Bo, Wang Liang, Shi Li-Na, Wu Xiao, Miao Wei
Graduate School of Qinghai University, Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China.
Department of Gastrointestinal Oncology Surgery, Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China.
World J Gastrointest Surg. 2025 Jul 27;17(7):106560. doi: 10.4240/wjgs.v17.i7.106560.
At present, prophylactic ileostomy is commonly used to protect distal intestinal anastomoses, particularly during the recovery period following colorectal surgery. However, after the ileum is returned to the abdominal cavity, abdominal closure using traditional vertical interrupted suturing is associated with a higher incidence of wound infections. For patients undergoing ileostomy closure, selecting an appropriate suturing method for the skin incision at the stoma site is crucial for improving patient prognosis.
To investigate the impact of three different skin suturing methods at the ileostomy closure site on patient prognosis.
Thirty patients who underwent ileostomy closure at the Affiliated Hospital of Qinghai University between January 2024 and October 2024 were selected based on inclusion and exclusion criteria. The patients were divided into three groups: The purse-string suture group, the cross-suture group, and the vertical interrupted suture group, with 10 cases in each group. The purse-string suture group, cross-suture group, and vertical interrupted suture group used purse-string, cross, and vertical interrupted suturing methods, respectively, for the skin incision at the ileostomy closure site.
There were no statistically significant differences among the three groups in terms of operative time, intraoperative blood loss, time to resume liquid diet, time to first bowel movement, postoperative hospital stay, hospitalization costs, or levels of white blood cell count, hemoglobin, and albumin on the third postoperative day ( > 0.05). Nevertheless, significant differences ( < 0.05) were observed in incision suture removal time, wound healing time, C-reactive protein levels on the third postoperative day, visual analog scale pain scores during the first three postoperative days, and the incidence of surgical site infection. Overall, the therapeutic outcomes of the purse-string suture group and the cross-suture group were superior to the vertical interrupted suture group.
Using purse-string or cross-suturing methods for skin incision at the ileostomy closure site can shorten wound healing and suture removal times, reduce surgical site infection incidence and postoperative inflammatory response, alleviate incision pain, and promote rapid postoperative recovery.
目前，预防性回肠造口术常用于保护远端肠道吻合口，尤其是在结直肠手术后的恢复期。然而，回肠还纳腹腔后，采用传统的垂直间断缝合进行腹壁关闭，伤口感染发生率较高。对于接受回肠造口关闭术的患者，选择合适的造口部位皮肤切口缝合方法对改善患者预后至关重要。
探讨回肠造口关闭部位三种不同皮肤缝合方法对患者预后的影响。
根据纳入和排除标准，选取2024年1月至2024年10月在青海大学附属医院接受回肠造口关闭术的30例患者。将患者分为三组：荷包缝合组、交叉缝合组和垂直间断缝合组，每组10例。荷包缝合组、交叉缝合组和垂直间断缝合组分别采用荷包、交叉和垂直间断缝合方法对回肠造口关闭部位的皮肤切口进行缝合。
三组患者在手术时间、术中出血量、恢复流食时间、首次排便时间、术后住院时间、住院费用以及术后第3天白细胞计数、血红蛋白和白蛋白水平方面，差异均无统计学意义（>0.05）。然而，在切口缝线拆除时间、伤口愈合时间、术后第3天C反应蛋白水平、术后前3天视觉模拟评分疼痛评分以及手术部位感染发生率方面，差异有统计学意义（<0.05）。总体而言，荷包缝合组和交叉缝合组的治疗效果优于垂直间断缝合组。
在回肠造口关闭部位的皮肤切口采用荷包或交叉缝合方法，可缩短伤口愈合和缝线拆除时间，降低手术部位感染发生率和术后炎症反应，减轻切口疼痛，促进术后快速恢复。
