142 Comparison of Patients’ Satisfaction Outcome of Primary Closure and Traditional Volcano Dressing Following Ileostomy Reversal

Abstract

Abstract Introduction Reversal of ileostomy is usually last step following major surgery. For patient this is quite significant procedure, and the outcome is vital. Not only they achieve continuity of GI tract again, but they can live without stoma. Providing them with skin closure that results in minimal scaring can improve patient satisfaction with cosmetic outcome of surgery. Method I have designed patient outcome and satisfaction questionnaire over 2 hospital sites. One hospital performs in majority of cases traditional volcano dressing, while the other attempts primary closure. Results 50 patients were included in total. One group (25 patients) underwent closure with traditional volcano approach while the other (25 patients) had primary closure of skin. The patients with the volcano dressing needed further visits to health care providers for dressing change and this had huge impact on their recovery. From the patients who had primary closure, 2 patients had minor wound infection with partial wound breakdown. The rest of a group healed with no complications. Patients in the primary closure group were satisfied with cosmetic result after the surgery while only 32% of patients from the volcano group have been satisfied with the cosmetic result. However, this was not related to the overall satisfaction from surgical outcome. Conclusions Primary closure is a very plausible option and when performed correctly, has minimal complications. It results in longer but more cosmetically acceptable scar than volcano dressing. Overall patients' satisfaction is mainly guided by the functional result of surgery but the cosmesis should be considered when planning ileostomy reversal.