The Outcome of Purse-string Versus Conventional Wound Closure Techniques in Patients Undergoing Stoma Reversal: A Randomized Controlled Trial
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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.
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Which technique is best when doing a stoma reversal, linear or purse string? Let's take a look. I'm Lizzie Lee from Cincinnati Children's Hospital, and this is an article that you should know about. The Children's Hospital in Pakistan conducted a randomized control trial, including 124 patients in 2021 to 2022 who needed a stoma reversal. Their aim was to compare surgical site infections and cosmetic outcomes of scars in patients who were getting the purse string or linear skin closure techniques. So what did they find? The purse string closure group had way fewer surgical site infections and much better scar quality compared to the linear closure group. So when reversing a stoma, purse string closure technique is the best way to do it. Let us know what you think in the comments below and stay tuned for more articles that you should know about.