Risk factors for surgical site infection after stoma closure comparison between pursestring wound closure and conventional linear wound closure: Propensity score matching analysis

Am J Surg. 2018 Jan;215(1):58-61. doi: 10.1016/j.amjsurg.2017.09.031. Epub 2017 Oct 6.

Abstract

Purpose: Stoma closure has been associated with a high rate of surgical site infection (SSI) and the optimal skin closure method is still controversial. The aim of this study was to compare the short-term and long-term outcomes between the conventional linear closure (CC) and the persestring closure (PC) using propensity score matching analysis.

Methods: We analysed the data of 360 patients who underwent stoma closure with CC or PC between January 2000 and December 2014. The propensity score was calculated from age, gender, body mass index, primary disease, type of stoma, diabetes mellitus, history of smoking, steroid use, the American Society of Anesthesiologists score, Prognostic Nutritional Index and modified Glasgow Prognostic Score.

Results: There was no difference in operative variables between the two groups. The CC group and the PC group were comparable with regards to overall SSI (25.0 vs. 7.8%; P = 0.007), superficial SSI (21.9 vs. 4.7%; P = 0.003). Significant risk factor for SSI was conventional linear closure (OR, 4.14; 95% CI, 1.448-13.91).

Conclusion: Our study suggests that a pursestring stoma closure leads to less SSI.

Keywords: Propensity score matching analysis; Pursestring wound closure; Surgical site infection.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Propensity Score
  • Retrospective Studies
  • Risk Factors
  • Surgical Stomas*
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology*
  • Surgical Wound Infection / prevention & control
  • Suture Techniques*
  • Young Adult