Sistema de Salut de Catalunya
Institut Català de la Salut
[Menegon Tasselli F, Fuschillo G] Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Policlinico CS, Naples, Italy. [Pata F] Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy. [Signoriello G] Department of Mental Health and Preventive Medicine, Chair of Statistics, University of Campania “Luigi Vanvitelli”, Naples, Italy. [Bondurri A] Department of General Surgery, Department of Biomedical and Clinical Sciences, Luigi Sacco” University Hospital, Milan, Italy. [Sciaudone G] Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, Campobasso, Italy. [Pellino G] Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Policlinico CS, Naples, Italy. Unitat de Cirurgia de Còlon i Recte, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain
Vall d'Hebron Barcelona Hospital Campus
2025-05-15T07:31:11Z
2025-05-15T07:31:11Z
2025-04-05
Ostomy closure; Postoperative complications; Surgical wound infection
Cierre de ostomía; Complicaciones postoperatorias; Infección de herida quirúrgica
Tancament d'ostomia; Complicacions postoperatòries; Infecció de la ferida quirúrgica
Background Surgical site infections (SSI) are the most common complication after stoma closure. Circular skin closure (CSC) has been proposed to reduce SSI with comparable or even better outcomes than conventional primary sutures (PS). The aim of this meta-analysis is to compare circular with primary skin closure in stoma closure. Method A systematic review of the literature was performed for articles published between January 2010 and June 2023, including all randomized control trials (RCT) on wound infection of adult patients following stoma reversal. The primary outcome was 30-day SSI; secondary outcomes were operative time, length of stay, and incisional hernia. Results Eight RCTs were identified that included a total of 606 patients undergoing stoma closure surgery. Four percent of patients in the CSC group developed SSI, compared to 27% of patients undergoing PS. The 30-day SSI rate was lower after the circular skin closure (OR 0.11, 95% CI 0.06–0.21; p < 0.00001, I2 = 0%). There was no difference in the operative time (99.2 vs 103.5 min; MD − 0.17, 95% CI − 0.37, 0.03; p = 0.10), length of stay (7.1 vs 7.7 days; MD − 0.34, 95% CI − 0.55, − 0.12; p = 0.002), and incisional hernia rate (2% vs 4%; OR 0.61, 95% CI 0.23, 1.60; p = 0.31). Conclusion CSC is associated with lower SSI rate and should be preferred to linear skin closure technique after stoma closure surgery.
Article
Published version
English
Infeccions quirúrgiques; Hèrnia; Cirurgia - Complicacions; DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications::Surgical Wound Infection; ANATOMY::Tissues::Surgically-Created Structures::Surgical Stomas; Other subheadings::Other subheadings::Other subheadings::/adverse effects; DISEASES::Pathological Conditions, Signs and Symptoms::Pathological Conditions, Anatomical::Hernia::Incisional Hernia; ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias::infección de la herida quirúrgica; ANATOMÍA::tejidos::estructuras creadas quirúrgicamente::estomas quirúrgicos; Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos; ENFERMEDADES::afecciones patológicas, signos y síntomas::afecciones patológicas anatómicas::hernia::eventración
Springer
Techniques in Coloproctology;29
https://doi.org/10.1007/s10151-025-03135-1
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
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