A beneficial effect of purse-string skin closure after ileostomy takedown: A retrospective cohort study

• We investigated the outcomes of purse-string closure (PS) after ileostomy repair.
• PS had a lower overall complication rate than the linear closure.
• PS had a lower surgical site infection rate than the linear closure.
• PS method was independently associated with a lower risk of surgical site infection.
• The postoperative pain scores did not differ between two groups.

ObjectivesThe aim of this study was to investigate the clinical benefits of purse-string skin closure (PS) in daily practice compared with conventional linear skin closure (CL) after ileostomy takedown in Korean population.MethodsThese retrospectively collected data were based on 157 consecutive patients who underwent ileostomy takedown between November 2010 and September 2011. Before March, 2011, CL was performed in 79 patients. Thereafter, PS was performed in 78 patients. The medical records including pain score recorded daily were reviewed and the postoperative outcomes, including SSI, were analyzed.ResultsPS group had a significantly lower overall complication rate than the CL group (8.97% vs. 25.32%, p = 0.010). Among complications, PS group had a significantly lower SSI rate than the CL group (0% vs. 11.39%, p = 0.003). After adjusted for other risk factors (smoking, body mass index, anastomosis method), PS method was associated significantly and independently with a lower SSI rate than CL method (adjusted odds ratio: 26.63, 95% confidence interval: 3.02–267.70, p = 0.001). And the two groups did not differ in terms of postoperative pain (p = 0.323) or pain pattern (p = 0.548).ConclusionIn daily practice, PS had a beneficial effect on SSI in patients who underwent ileostomy takedown in the Korean population.