Purse-String Closure vs Conventional Direct Closure of Wounds after Stoma Reversal: A Prospective Randomized Controlled Study

Abstract

INTRODUCTION: Surgical site infection (SSI) is one of the most frequent complications after ileostomy closure. Our prospective randomized controlled trial aims to compare 2 operative techniques used to close the wound after ileostomy closure, the direct suture and purse-string suture. The main endpoint was the SSI rate. Secondary endpoint was cosmetic outcomes. METHODS: A total of 100 patients were enrolled and included in the statistical analysis; 50 patients were randomized into the purse-string suture group and 50 were randomized into the direct suture group. Follow-up was performed within 2 days after operation, at discharge, 1 month and 3 months after the operation. RESULTS: The purse-string suture group had a lower number of SSI compared with the direct suture group (2 vs 14, p = 0.007). The secondary outcome of cosmesis was similar in the 2 groups, with no statistically significant difference. CONCLUSION: In our experience, the purse-string suture has a lower risk of stoma site SSI. This type of closure should be considered as standard of care after ileostomy reversal.