Literature DB >> 21626012

Cosmetic and functional outcome after stoma site skin closure in children.

Lisa Ortqvist1, Markus Almström, Maria Ojmyr-Joelsson, Helena Wigander, Agneta Währner, Tomas Wester.   

Abstract

PURPOSE: To evaluate the functional and cosmetic outcome of stoma closure in children after straight closure (SC) versus purse-string closure (PSC).
METHODS: The patients (n = 33, age 16-159 months), operated at a median age of 6 months (1-121 months) between 2007 and 2009 in our hospital, were studied to evaluate whether the proposed superiority of the PSC technique is applicable in children. The patients were operated with SC or PSC. The most common causes of the temporary stomas were necrotizing enterocolitis, Hirschsprung's disease and anal atresia. A validated scoring-system questionnaire (patient and observer scar assessment scale),POSAS was sent to the parents containing questions concerning pain, itchiness, colour, stiffness, thickness and irregularity of the scar completed by a visual analogue scale to evaluate an overall opinion.
RESULTS: 25 families (SC; n = 12, PSC;n = 13) participated. The differences between the two groups are largest, although not statistically significant, for discoloration, stiffness, thickness and irregularity, with better scores in the PSC group. There was a better total POSAS score in the PSC group whilst the VAS shows very modest differences.
CONCLUSION: Our study indicates advantages of the PSC technique after stoma closure with better cosmetic and functional outcome. To be able to show statistically significant differences between PSC and SC a larger study would be useful.

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Mesh:

Year:  2011        PMID: 21626012     DOI: 10.1007/s00383-011-2933-1

Source DB:  PubMed          Journal:  Pediatr Surg Int        ISSN: 0179-0358            Impact factor:   1.827


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4.  Primary closure of the skin after stoma closure. Management of wound infections is easy without (long-term) complications.

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6.  Wound infection following stoma takedown: primary skin closure versus subcuticular purse-string suture.

Authors:  Thao T Marquez; Dimitrios Christoforidis; Anasooya Abraham; Robert D Madoff; David A Rothenberger
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7.  Reliable and feasible evaluation of linear scars by the Patient and Observer Scar Assessment Scale.

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8.  A technique for wound closure that minimizes sepsis after stoma closure.

Authors:  Christopher Derek Sutton; Nigel Williams; Leslie-Jayne Marshall; Geraint Lloyd; William Michael Thomas
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9.  The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation.

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Review 10.  Current scales for assessing human scarring: a review.

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1.  Ostomy Closures in Children: Variations in Perioperative Care Do Not Change the Outcome.

Authors:  Yusuf Hakan Çavuşoğlu; Ayşe Karaman; Çağatay Evrim Afşarlar; İbrahim Karaman; Derya Erdoğan; İsmet Faruk Özgüner
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2.  A comparison of surgical site infections in children after stoma reversal between purse-string and linear closure.

Authors:  Chanathip Sayuen; Ratiyaporn Phannua; Sinobol Chusilp; Patchareeporn Tanming; Suchat Areemit; Katawaetee Decharun; Paisarn Vejchapipat; Kanokrat Thaiwatcharamas
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Review 3.  Purse-string approximation is superior to primary skin closure following stoma reversal: a systematic review and meta-analysis.

Authors:  D P McCartan; J P Burke; S R Walsh; J C Coffey
Journal:  Tech Coloproctol       Date:  2013-01-25       Impact factor: 3.781

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