Prospective randomized clinical trial of wound closure technique after ileostomy closure

Authors:JP Ghildiyal , Ajay Agrawal , Rohit Sood , Kumar Amritesh
Int J Biol Med Res. 2013; 4(2): 3070- 3072  |  PDF File


ABSTRACT: PROSPECTIVE RANDOMISED CLINICAL TRIAL OF WOUND CLOSURE TECHNIQUE AFTER ILEOSTOMY CLOSURE Background: Surgical site infection (SSI) is a frequent problem following contaminated surgery. Reversal of ileostomy is one such type of surgery. There are various techniques described to deal with it and still debated in existing literature. The common methods described are primary closure, delayed primary closure, just packing of wound; circumferential subcuticular wound closure or purse string closure of wound. There is wide variation in wound infection rate in literature and no common consensus is found. Therefore, we conducted a study to compare linear subdermal closure with primary closure of wound after ileostomy reversal. Aim: To demonstrate that the technique of linear subdermal closure of wound after ileostomy closure is safe and more effective in reducing wound infection. Method: Sixty four patients underwent ileostomy closure from May 2010 to May 2012. We randomly divided the patients in two groups. Group A (n = 34) underwent subdermal closure of wound and group B (n=30) underwent primary closure of wound. Primary outcome was measured for wound infection (SSI) and secondary outcome was measured for wound healing. Result: There was no wound infection in group A (0%). In group B the wound infection occurred in 4 patients (13.3%). There was significant reduction in SSI rate of subdermal closure (p = <0.05). There was no difference in wound healing and mean duration was 9 days (range 7-11 days) in both the groups. Conclusion: The linear subdermal wound closure produced less wound infection as compared to primary closure. Keywords: Ileostomy closure. Ileostomy reversal. Wound infection. Surgical Site Infection