Primary skin closure in reversal of loop ileostomy: an effective technique

Abstract

Established practice in reversal of loop ileostomy relies upon secondary intention healing of the skin defect. This study demonstrates that rapid, uncomplicated healing of the skin defect can be achieved by primary skin closure of the trephine. A retrospective case note review of 29 consecutive patients who underwent primary skin closure of the stomal trephine during loop ileostomy closure over a 28-month period is presented. Data is examined for complications and healing times with specific reference to wound infection. Results are compared with published data on secondary intention healing of the trephine. Wound infection occurred in 2 cases (7%), both being superficial infections responding to antibiotics and removal of sutures. This compares favourably to published infection rates for secondary intention trephine healing and avoids long healing times with costly wound care. Primary skin closure is a safe and effective technique in loop ileostomy reversal and avoids long healing times associated with traditional methods.