The Outcome of Purse-string Versus Conventional Wound Closure Techniques in Patients Undergoing Stoma Reversal: A Randomized Controlled Trial
Infographic · Aug 2024 · 1 min read
In brief
In brief
Randomized trial of 124 pediatric patients demonstrates purse-string closure significantly reduces surgical site infections (14.5% vs 38.7%) and improves scar cosmesis compared to conventional linear closure after stoma reversal. The technique's drainage capability appears to lower infection risk while delivering superior aesthetic outcomes.
- Purse-string closure reduces surgical site infection rates in stoma reversal from 38.7% to 14.5% compared to conventional linear closure.
- Purse-string technique achieves 'good' scar quality in 63% of patients versus only 22.6% with linear closure (Manchester scar scale).
- The purse-string method's inherent drainage capability likely accounts for lower SSI rates by preventing wound exudate accumulation.
- Both closure techniques result in similar hospital length of stay, making purse-string a viable alternative without added recovery time.
- 124-patient RCT demonstrates purse-string closure as superior option for pediatric stoma reversal regarding infection prevention and cosmesis.
Written by the GCMD Library team from the infographic.
Assad Ameer, Muhammad Bilal Mirza, Nabila Talat
Background: Patients undergoing stoma reversal may experience surgical site infections and poor scarring. A purse-string closure approach may lower the incidence of surgical site infections due to its inherent ability to drain wound exudates. This study compared the frequency of surgical site infections and the cosmetic outlook of the scar among patients undergoing stoma reversal with linear and purse-string skin closure techniques.
Setting and duration: Department of Pediatric Surgery, University of Child Health Sciences Lahore with a duration of one year (June 2021 to June 2022).
Methods: This randomized controlled trial (TCTR20210417001) was conducted with IRB approval. A total of 124 patients undergoing stoma reversal were randomly assigned to two groups (62 in each): Group A received conventional linear skin closure, while Group B received purse-string wound closure. The study evaluated surgical site infection, cosmetic outcome, and length of stay.
Results: Both groups had similar age, gender ratio, indication for surgery, and length of stay. The purse-string group had a significantly lower incidence of SSI (38.7 % vs. 14.5 %; p = 0.002) and better scar quality (Manchester scar scale showed 'good' scar quality in 63 % of patients vs. 22.6 % in the linear closure group, p-value <0.0001).
Conclusion: The purse-string technique for skin closure resulted in fewer surgical site infections and improved scar appearance.