Fabio Rondelli1, Laura Franco2, Ruben Carlo Balzarotti Canger3, Graziano Ceccarelli4, Cecilia Becattini5, Walter Bugiantella6. 1. General Surgery, "San Giovanni Battista" Hospital, USL Umbria2, Foligno, Italy; Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy. Electronic address: rondellif@hotmail.com. 2. Internal Vascular and Emergency Medicine, University of Perugia, Perugia, Italy. Electronic address: laura.franco@unipg.it. 3. General Surgery, Hospital of Lugano, Lugano, Switzerland. Electronic address: ruben.balzarotti@eoc.ch. 4. General Surgery, "San Giovanni Battista" Hospital, USL Umbria2, Foligno, Italy. Electronic address: graziano.ceccarelli@uslumbria2.it. 5. Internal Vascular and Emergency Medicine, University of Perugia, Perugia, Italy. Electronic address: cecilia.becattini@unipg.it. 6. General Surgery, "San Giovanni Battista" Hospital, USL Umbria2, Foligno, Italy. Electronic address: walterbugiantella@alice.it.
Abstract
PURPOSE: Surgical site infection (SSI) is one of the most frequent complications after stoma closure and the optimal skin closure technique is still not clear. The goal of this review was to compare outcomes with purse-string closure technique (PSC) versus conventional closure technique (CCT) for skin closure after stoma reversal. METHODS: We performed a systematic review and meta-analysis of available randomized controlled trials (RCTs) to compare SSI rate within 30 days, operative time, hospital stay, incisional hernia and intestinal obstruction rates between PSC and CCT. RESULTS: The pooled analysis of 5 studies showed a statically significant lower rate of SSI in favor of PSC compared to CCT (OR -0.24; 95% CI -0.32, - 0.15; p < 0.00001). No statistically significant differences were observed in the operative time (OR -0.05; 95% CI -3.95, 3.84; p = 0.98) and in the length of hospital stay (OR -0.20; 95% CI -0.76, 0.36; p = 0.48), between the two techniques. Additionally, two out of the five studies provided data on incisional hernia and intestinal obstruction and the pooled analysis revealed no statistically significant differences between PSC and CCT techniques: incisional hernia (OR 0.81, 95% CI 0.27-2.47; p = 0.71) and intestinal obstruction (OR 1.07, 95% CI 0.41-2.84; p = 0.88). CONCLUSIONS: The analysis of 5 RCTs showed that SSI rate is statistically significant lower when PSC is performed, compared to CCT. Whereas, no significant differences were found between the two techniques with regards to operative time, length of hospital stay, incisional hernia and intestinal obstruction rates.
PURPOSE: Surgical site infection (SSI) is one of the most frequent complications after stoma closure and the optimal skin closure technique is still not clear. The goal of this review was to compare outcomes with purse-string closure technique (PSC) versus conventional closure technique (CCT) for skin closure after stoma reversal. METHODS: We performed a systematic review and meta-analysis of available randomized controlled trials (RCTs) to compare SSI rate within 30 days, operative time, hospital stay, incisional hernia and intestinal obstruction rates between PSC and CCT. RESULTS: The pooled analysis of 5 studies showed a statically significant lower rate of SSI in favor of PSC compared to CCT (OR -0.24; 95% CI -0.32, - 0.15; p < 0.00001). No statistically significant differences were observed in the operative time (OR -0.05; 95% CI -3.95, 3.84; p = 0.98) and in the length of hospital stay (OR -0.20; 95% CI -0.76, 0.36; p = 0.48), between the two techniques. Additionally, two out of the five studies provided data on incisional hernia and intestinal obstruction and the pooled analysis revealed no statistically significant differences between PSC and CCT techniques: incisional hernia (OR 0.81, 95% CI 0.27-2.47; p = 0.71) and intestinal obstruction (OR 1.07, 95% CI 0.41-2.84; p = 0.88). CONCLUSIONS: The analysis of 5 RCTs showed that SSI rate is statistically significant lower when PSC is performed, compared to CCT. Whereas, no significant differences were found between the two techniques with regards to operative time, length of hospital stay, incisional hernia and intestinal obstruction rates.
Authors: F Ferrara; D Parini; A Bondurri; M Veltri; M Barbierato; F Pata; F Cattaneo; A Tafuri; C Forni; G Roveron; G Rizzo Journal: Tech Coloproctol Date: 2019-10-12 Impact factor: 3.781
Authors: M Wierdak; M Pisarska-Adamczyk; M Wysocki; P Major; K Kołodziejska; M Nowakowski; T Vongsurbchart; M Pędziwiatr Journal: Tech Coloproctol Date: 2020-11-07 Impact factor: 3.781
Authors: Ernest Z Low; Timothy S Nugent; Niall J O'Sullivan; Dara Kavanagh; John O Larkin; Paul H McCormick; Brian J Mehigan; Michael E Kelly Journal: Int J Colorectal Dis Date: 2022-04-29 Impact factor: 2.796