Comparison of Primary Versus Secondary Closure of Ileostomy

Abstract

Background: Morbidity after stoma closure, however, is not negligible and the most common complication is postoperative surgical site infection. There is no consensus on the ideal closure technique of the stoma wound to minimize postoperative wound infection and multiple techniques have been proposed. The aim of this study was to compare the efficacy of primary versus secondary closure of ileostomy reversal skin wound in terms of wound infection. Material and Methods: This randomized controlled trial included 60 patients, which were divided into two groups, primary closure (A) in which wound was primarily closed at the end of procedure and secondary closure (B) in which wound was left open for secondary healing, after fullfilling the inclusive and exclusive criteria from november 2011 to october 2012. Wound infection was noted postoperatively and was recorded in a proforma. Data was analyzed using SPSS16. Results: There were 30 patients in each group.The male to female ratio and mean age ±S.D in group A and B were ( 3.3 : 1 and 2.75 : 1, P= .754 ) and ( 40.13 ± 1.32 and 41.6 ± 1.44, P= .902) )respectively. The incidence of wound infection in primary skin wound closure was in 7 ( 11.7% ) patients and 6 ( 10% ) patients in secondary wound closure ( P= .754 ) following ileostomy closure. There was no statistically significant effect of age and sex on the efficacy of primary versus secondary closure of ileostomy reversal skin wound, with the p- value of .807 and .587 respectively. The length of hospital stay was similar for both groups. Conclusion: Primary closure should be encouraged as a routine method of closure of ileostomy-reversal skin wound.

Keywords

• ileostomy reversal
• wound closure
• wound infection