Clinical Outcomes of Patients undergoing Intracutaneously and Transcutaneously Sutured Ileostomy to Prevent Stoma Related Complications- A Cohort Study

Abstract

Introduction: Ileostomy plays an important role in the emergency settings when faecal diversion procedure would be lifesaving. As it is known that each procedure has some complications, ileostomy is no different than having a plethora of complications ranging from early to late complications. Aim: To determine outcomes in patients undergoing intracutaneously compared with transcutaneously sutured ileostomy to prevent stoma related complications. Materials and Methods: A prospective cohort study was conducted on 130 patients who received a loop ileostomy from October 2018 till August 2020. Patients were placed in either transcutaneously sutured ileostomy group (n=70) or intracutaneously sutured ileostomy group (n=60), on the basis of surgeon’s choice. Patients were followed for a period of three months after surgery and its outcomes (complications like peristomal dermatitis, ischaemia, prolapse etc.,) were assessed and compared using Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM Corp.) and independent sample’s t-test. Results: The mean age for intracutaneously sutured ileostomy was 38.62±19.01 years and that for transcutaneously sutured ileostomy was 33.89±13.25 years. There was no significant difference between the groups in terms of age (p=0.420). There was no significant difference between the various groups in terms of distribution of gender (p=0.753). Nearly half of the patients (43.9%) suffered from peristomal leakage 33 (55%) in intracutaneously sutured ileostomy and 24 (34.3%) in transcutaneously sutured ileostomy (p-value- 0.018) leading to peristomal dermatitis. Conclusion: Transcutaneous suturing technique have shown to decrease incidence of peristomal leakage leading to skin irritation (peristomal dermatitis). Other stoma related complications did not differ between the two techniques.

Keywords

• emergency
• peristomal dermatitis
• tubercular
• typhoid perforation