Cosmetic and functional outcome after stoma site skin closure in children

Örtqvist, Lisa; Almström, Markus; Öjmyr-Joelsson, Maria; Wigander, Helena; Währner, Agneta; Wester, Tomas

doi:10.1007/s00383-011-2933-1

Cited by 10 publications

(5 citation statements)

References 13 publications

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“…The POSAS was introduced in 2004 and aims to measure the quality of scar tissue through a patient and observer module. The questionnaire has previously been used as a proxy model to describe scars in children [16,17]. No observer evaluation of the physical appearance could be performed due to lack of ethical approval, and consequently only the patient module was used.…”

Section: Instrumentsmentioning

confidence: 99%

Health-related quality of life and scar satisfaction in a cohort of children operated on for sacrococcygeal teratoma

Hambraeus

Hagander

Arnbjörnsson

et al. 2020

Health Qual Life Outcomes

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Aim: The aims of this study were to evaluate health-related quality of life (HRQoL) in children with sacrococcygeal teratoma and to explore the effect of the scar on physical, emotional and behavioral aspects. Methods: A cohort of children operated on for sacrococcygeal teratoma between 2000 and 2013 at Lund University Hospital, Sweden, and their parents were interviewed. HRQoL was evaluated with PedsQL, and scar satisfaction was estimated through Patient Observer Scar Assessment Score (POSA). Results: All eligible children (n = 17) were included (100% response rate). Median age was 7.3 years (range 3.5-16.0). Mean total PedsQL score was 92.3 (range 72.0 to 99.0). Patients with comorbidity scored lower (87.5) than those without (95.0) (p < 0.05). Pain during sitting down was reported by two (20%) patients, and itching was reported by another two patients (20%) aged > 8 years. No children reported that they avoided situations due to the scar, and most (80% of children and 90% of parents) reported absent or only mild negative emotions when considering the scar. Conclusion: Children with sacrococcygeal teratoma had a good overall HRQoL, but comorbidity reduced the outcome. A few children reported scar-related impact on physical, behavioral and emotional aspects.

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Section: Instrumentsmentioning

confidence: 99%

Health-related quality of life and scar satisfaction in a cohort of children operated on for sacrococcygeal teratoma

Hambraeus

Hagander

Arnbjörnsson

et al. 2020

Health Qual Life Outcomes

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“…Indeed, two systematic reviews and meta-analyses have shown that PSC significantly reduces the risk of SSI compared to traditional LSC [ 11 , 15 ]. Some reports have also noted improvements in aesthetic outcomes [ 16 ]. On the other hand, PSC requires daily wound cleaning and takes longer until complete wound closure [ 17 ], which are its disadvantages.…”

Section: Discussionmentioning

confidence: 99%

A case series of prophylactic negative pressure wound therapy use with purse-string closure in stoma closure wounds in infants

Kumata,

Ishii,

Ishii

et al. 2024

surg case rep

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Background The study introduces the application of negative pressure wound therapy (NPWT) in pediatric stoma closure, emphasizing the importance of enhancing aesthetics and minimizing surgical site infections (SSI). Case presentation The case series involves four infants undergoing non-umbilical stoma closure with a combination of purse-string closure (PSC) and NPWT, focusing on aesthetic outcomes and infection prevention. NPWT was initiated immediately after surgery, and patients were monitored every 3–4 days. Notably, none of the four infants experienced SSI or other complications. The patients adequately tolerated NPWT, with no significant adverse events. Furthermore, Manchester Scar Scale (MSS) was 9 [7–10], and Patient and Observer Scar Assessment Scale (POSAS) (observer) was 12.5 [12–19], POSAS (patient) was 12.5 [11–16] (all median values [minimum–maximum]), indicating that excellent aesthetic outcomes were achieved. Discussion We emphasizes the significance of aesthetics in pediatric patients; in addition, our findings demonstrate that four infants who received NPWT combined with PSC achieved superior outcomes that did the most recent four infants who underwent PSC only at our institution. It also addresses the risk of SSI in stoma closure and discusses the pros and potential cons of using NPWT in pediatric cases, underlining the need for further research and the accumulation of additional reports. Conclusions This is the inaugural report of prophylactic NPWT for pediatric stoma closure, emphasizing the effectiveness of combining PSC and NPWT for SSI prevention and improved aesthetics. The study calls for additional research and reports on NPWT in pediatric cases to further solidify its benefits in this patient population.

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“…In the non-umbilical stoma group, the wound edges may be di cult to t because we skin suturing during stoma closure used purse-string skin sutures in many cases. But pursestring skin sutures haves been reported to have less surgical site infections [25], shorter wound length [26], and better cosmetic results [27] compared with straight closures, so we chose that method. The at abdominal wall or the depressed umbilical region may have had the greatest in uence on the results, but the possibility of bias, as described above, remains an issue for further investigation, including the expansion of this technique.…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of pediatric umbilical loop stomas: Two decades of experience from a single institution

Ishii,

Kumata,

Ishii

et al. 2023

Preprint

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Purpose Since pediatric stomas are often temporary, their creation, management, and closure should be simple, with minimal complications and excellent cosmetic results. We began employing umbilical stomas in 2000. This study aimed to characterize the ingenuity and utility of umbilical stomas and provide a quantitative evaluation of their cosmetic outcomes. Methods We examined cases of stoma construction and closure surgery performed in our department from January 2000 to December 2022. The umbilical and non-umbilical stoma groups included 54 and 42 cases, respectively, and the findings for both groups were compared and analyzed. Results The two groups showed no significant differences in the incidence of complications. The Manchester Scar Scale score for the umbilical stoma group (8.42±1.85) was significantly better than that for the non-umbilical stoma group (16.31±2.96; P<0.01). Likewise, in Patient and Observer Scar Assessment Scale assessments, the umbilical stoma group showed significantly better scores in both the observer scale (9.48±2.50 vs. 21.78±7.26; P<0.01) and the patient scale (10.5±1.39 vs. 22.40±7.35; P<0.01). Conclusions Umbilical stomas are easy to manage and yield an inconspicuous closure incision with excellent cosmetic outcomes. Although patient selection is important, pediatric umbilical stomas are a valuable option that can be actively employed.

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Cosmetic and functional outcome after stoma site skin closure in children

Cited by 10 publications

References 13 publications

Health-related quality of life and scar satisfaction in a cohort of children operated on for sacrococcygeal teratoma

Health-related quality of life and scar satisfaction in a cohort of children operated on for sacrococcygeal teratoma

A case series of prophylactic negative pressure wound therapy use with purse-string closure in stoma closure wounds in infants

Quantitative evaluation of pediatric umbilical loop stomas: Two decades of experience from a single institution

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