Letter to the Editor: Alternative Stomal Closure Technique

jpedsurg.org

We read the recently published article by Ameer et al. comparing outcomes of purse-string and conventional linear closure techniques for stoma reversals [1]. In short, the authors performed a randomized controlled trial to compare these two techniques, finding that purse-string closure led to significantly lower rates of surgical site infections (SSIs) and better scar quality. While we know from previous data that purse-string closures should reduce SSI risk, we were surprised by the second finding as we have moved away from purse-string suture techniques based on long-term cosmesis concern [2,3].

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Article · Nov 2023 · 1 min read

In brief

This letter responds to a randomized trial comparing purse-string versus linear closure for stoma reversals. The authors question findings on scar cosmesis, noting their institution moved away from purse-string technique due to long-term cosmetic concerns despite its infection-reduction benefits.

Purse-string closure for stoma reversal significantly reduces surgical site infection rates compared to conventional linear closure.
Recent RCT found purse-string technique resulted in better scar quality, contrary to some surgeons' long-term cosmesis concerns.
Previous literature supports purse-string closure for lower SSI risk, but cosmetic outcomes remain debated among practitioners.
Choice of stomal closure technique involves trade-offs between infection prevention and aesthetic considerations.

Written by the GCMD Library team from the article.

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