A protocol for skin closure after stoma reversal

Pemmaraju, Vishnu; Lansing, Shan S.; Husain, Syed

doi:10.1007/s10151-019-02033-7

Cited by 5 publications

(8 citation statements)

References 4 publications

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“…SSI is an important and common complication after stoma closure. Peristomal skin reportedly harbors a considerable number of enteric bacteria, and since the procedure also entails enteric anastomosis, stoma closure is considered a clean-contaminated procedure [10]. , c) Fig.…”

Section: Discussionmentioning

confidence: 99%

The technique for less infectious and earlier healing of stoma closure wound: Negative Pressure Wound Therapy with instillation and dwelling followed by primary closure

Yane

Hida

Makutani

et al. 2020

Preprint

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Background:Temporary stomas have been widely used to avoid the risk of complications such as anastomotic leakage after colorectal resection. Stoma closure is relatively easy; however, postoperative surgical site infection (SSI) may be a problem. Various methods have been used to reduce the incidence of SSI. We aimed to evaluate a new technique for stoma wound closure.Methods:We enrolled patients who underwent stoma closure at our hospital between September 2019 and May 2020. We selected patients who lived far from our hospital and had difficulty visiting the hospital regularly and who agreed to undergo this surgical technique. We used negative pressure wound therapy with instillation and dwelling (NPWTi-d) and delayed primary closure for these patients.Results:Four patients underwent NPWTi-d and delayed primary closure without the occurrence of SSI. The median postoperative hospital stay was 9 days (range: 7-14 days), and the median number of days to confirmation of epithelialization was 11.5 days (range: 10-16 days).Conclusion:The combined use of NPWTi-d and delayed primary closure for the stoma wound was very effective. This method may be a valuable new technique for wound management after stoma closure.

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Section: Discussionmentioning

confidence: 99%

The technique for less infectious and earlier healing of stoma closure wound: Negative Pressure Wound Therapy with instillation and dwelling followed by primary closure

Yane

Hida

Makutani

et al. 2020

Preprint

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“…A6 -A protocol for skin closure after stoma reversal 16 Se propone la técnica de cierre lineal con reversión de bordes y reducción del espacio muerto en pacientes cuya medición del grosor del tejido celular subcutáneo sea < 4 cm; con mejor resultado cosmético y disminución en la tasa de ISO.…”

Section: Eeuuunclassified

“…Se deben utilizar soluciones con alcohol como primera línea (clorhexidina con alcohol), para el lavado del sitio quirúrgico y preparación de la piel previo a la incisión, así como evitar la depilación del vello 16 (Nivel de evidencia II).…”

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Intervenciones de Enfermería en la reversión del estoma intestinal: revisión integrativa

Barriga

Garzón

2022

Rev Cuid

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Introducción: los estomas intestinales representan un impacto significativo en la calidad de vida de las personas; sin embargo, estos deben revertirse después de haberse restituido el tránsito intestinal o la resolución del proceso inflamatorio inicial. Por otro lado, la negación de la persona para su reversión puede deberse a la falta de información y orientación por parte de los profesionales de la salud. Por lo anterior es importante identificar las intervenciones de Enfermería en la atención de la persona con reversión del estoma intestinal. Materiales y métodos: se realizó una revisión integrativa de la literatura de alcance descriptivo en el período comprendido entre los años 2015 a 2020, a través de las bases de datos Wos, Pubmed, Scopus, Scielo y Cochrane. Se seleccionaron 36 artículos que cumplieron con los criterios de inclusión y exclusión con el respectivo análisis metodológico. Resultados: Se identificaron las siguientes intervenciones de Enfermería, para el preoperatorio: valoración preoperatoria, preparación intestinal y seguimiento a comorbilidades. El intraoperatorio: profilaxis, preparación de la piel, técnica quirúrgica y cierre de la pared abdominal. En el posoperatorio: cuidado de la herida quirúrgica, calidad de vida y educación. Discusión: es importante la reflexión sobre el tiempo de reversión, la técnica quirúrgica y la importancia de las intervenciones por Enfermería. Conclusión: Enfermería cumple un papel importante en la reversión del estoma, no solo por los cuidados físicos y la educación que se brinda, sino también en las intervenciones aplicables al contexto social y emocional que afectan el estilo de vida de la persona. Como citar este artículo: Gómez Barriga Norma Yaneth, Medina Garzón Mauricio. Intervenciones de Enfermería en la reversión del estoma intestinal: revisión integrativa. Revista Cuidarte. 2022;13(1):e2165. http://dx.doi.org/10.15649/cuidarte.2165

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“…4 As stoma reversal is a clean-contaminated procedure due to peristomal skin housing enteric bacteria, traditionally it should be allowed to heal by secondary intention. 11 Various techniques have been utilised to close stoma wounds, such as primary linear closure of wound, delayed skin closure, secondary closure, purse-string wound closure, and sub-dermal closure. There is a wide variation in wound infection rates among different techniques in literature.…”

Section: P R O V I S I O N a L L Ymentioning

confidence: 99%

Primary versus secondary closure of stoma reversal skin wound: randomized controlled trial

2022

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Objective: To compare the efficacy of primary versus secondary closure of stoma reversal skin wound in terms of wound infection. Method: The study was conducted at Surgical B Unit of Ayub Teaching Hospital, Abbottabad, Pakistan, from January 1 to December 31, 2020, and comprised adult patients of either gender undergoing stoma reversal. The patients were randomised into primary closure group A and secondary closure group B. Surgical procedure was similar in both the groups except the skin closure technique. In group A, skin was closed with interrupted polypropylene sutures, while in group B, wound was dressed with saline-soaked gauze daily using aseptic technique and was allowed to heal by secondary intention or delayed primary closure latter on. Postoperatively, the wound was assessed for infection till 30th postoperative day or complete wound healing. Data was analysed using SPSS 16. Results: Of the 50 patients, 35(70%) were males and 15(30%) were females. The overall mean age was 28±1.65years. There were 25(50%) patients in each of the two groups. There were 19(76%) males and 6(24%) females in group A with a mean age of 32±2.8years. There were 16(64%) males and 9(36%) females in group B with a mean age of 23±3.5years. Overall, 10(20%) patients had wound-site infections; 9(36%) in group A versus 1(4%) in group B (p=0.005). Frequency of wound infection with respect to gender, type of stoma and length of hospital stay was not significant (p>0.05). Conclusion: Secondary skin closure was found to be associated with significantly reduced wound infection rate after stoma reversal. Clinical Trial Number: NCT04785404. Link; https://clinicaltrials.gov/ct2/show/NCT04785404 Key Words: Stoma reversal, Primary closure, Secondary closure, Wound infection, Ileostomy, Colostomy.

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A protocol for skin closure after stoma reversal

Cited by 5 publications

References 4 publications

The technique for less infectious and earlier healing of stoma closure wound: Negative Pressure Wound Therapy with instillation and dwelling followed by primary closure

The technique for less infectious and earlier healing of stoma closure wound: Negative Pressure Wound Therapy with instillation and dwelling followed by primary closure

Intervenciones de Enfermería en la reversión del estoma intestinal: revisión integrativa

Primary versus secondary closure of stoma reversal skin wound: randomized controlled trial

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