Modified Primary Closure Method Could Decrease Surgical Site Infection Rate of Stoma Wound

Purpose. The most common problem after stoma closure is surgical-site infection (SSI), which is strongly associated with the characteristics of primary wound closure. The aim of this study was to investigate a modified primary wound closure method post stoma closure and evaluate the feasibility for decrease the incidence rate of perioperative SSI. Methods. Data on all stoma-closure patients performed over a 10-year period were collected retrospectively. The outcome of interest was a diagnosis of stoma-closure SSI as defined by the Centers for Disease Control and Prevention. Surgical techniques including modifications to the suture method, wound irrigation procedure and the addition of loose gauze compression are described. Patient characterizations and related clinical factors were evaluated for their independent effect on SSI rate. Results. One hundred and nineteen patients undergoing elective stoma closure were identified for evaluation. The patients had a mean age of 64.1 years and 68% of them were male. The preoperative diagnoses comprised colorectal cancer in 73 patients (61.3%) and benign disease in 46 patients (38.7%). The closed stomas included 19 loop ileostomas, 80 loop T-colostomas, 10 loop S-colostomas, and 10 end stomas. SSIs were identified in 2 patients (1.68%). Conclusions. Ourmodified primary suturemethod for stoma closure wound can reduce the incidence rate of surgical site infection while achieving acceptable cosmetic results.

關鍵字

Modified primary closure ； Surgical site infection ； Stoma closure wound

並列摘要

目的：造口關閉後最常見的問題是手術部位傷口感染，這與原始性傷口關閉方式的特性密切相關。本研究的目的是研究一種造口關閉後的改良性原始傷口關閉方式，並評估此方式在降低手術併發的手術部位傷口感染率的可行性。方法：本研究回溯收集10年的造口關閉患者的資料分析，並評估疾病控制和預防中心定義的造口關閉手術部位感染率。本研究描述了相關手術技術，包含對縫合方法的修改，傷口灌洗流程和增加鬆動紗布加壓，並評估分析患者臨床數值和相關臨床因素對手術部位傷口感染率的影響。結果：本研究收錄119名接受選擇性造口關閉的患者，平均年齡為64.1歲，其中68%為男性。術前診斷包括73例結直腸癌（61.3%）和46例良性疾病（38.7%）。造口種類包括19個迴腸造口，80個橫結腸造口，10個乙狀結腸造口和10個末端造口。在這之中，有2名患者發生了手術部位傷口感染（1.68%）。結論：我們改良的造口關閉後原始傷口縫合方法可以降低手術部位傷口感染的發生率，同時達到可接受的外觀。

並列關鍵字

改良性的原始關閉方式；手術部位傷口感染；造口關閉傷口

參考文獻

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