Primary linear closure with closed suction wound drain after ileostomy takedown

Abstract

Purpose: Wound infection after ileostomy takedown is one of the significant complications. Conventional linear closure has been reported to be associated with a significantly higher incidence of wound infection. We aimed to evaluate the surgical outcomes of primary linear closure with closed suction wound drain following a loop ileostomy takedown. Methods: Between October 2007 and October 2012, a total of 121 patients who underwent primary linear closure with closed suction wound drain after ileostomy takedown were included, and their surgical outcomes were compared with those of 34 patients who underwent delayed wound closure between July 2002 and September 2007 as a historical control group . Results: Between primary linear closure with closed suction wound drain group and delayed wound closure group, there were no differences of gender, age, body mass index, American Society of Anesthesiologists (ASA) scores and comorbidities such as pulmonary disease and hypertension and diabetes . The chemotherapy rate is similar in the two groups (group I, 52.9%; group II, 44.6%; P=0.39). There was a significant difference in wound infection (group I, 23.5%; group II, 5.6%; P=0.002). There was no significant difference in the length of postoperative hospital stay (P=0.26). Small bowel obstruction was not significantly different between the two groups (group I, 11.8%; group II, 7.4%; P=0.42). Conclusion: Primary linear wound closure with closed suction wound after a loop ileostomy takedown showed comparable outcomes, in terms of wound infection rates to those of delayed wound closure. Thus, primary linear wound closure with closed suction drain after a loop ileostomy takedown could be a good alternative to the delayed closure or purse-string closure.

Keywords

• ilestomy closure
• ileostomy takedown
• wound infection
• closed suction drain