Effect of Negative Pressure Wound Therapy on Surgical Site Infections following Stoma Reversal in Colorectal Surgery: A Meta-Analysis

Zhu, Jinming; Sun, Qi; Xu, Wenlong; Geng, Jun; Feng, Qiang; Zhao, Zhenguo; Li, Sen

doi:10.1080/08941939.2023.2175079

Cited by 4 publications

(2 citation statements)

References 47 publications

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“…Prior studies have explored a wide range of techniques for managing the former stoma site after stoma closure, including purse-string versus linear closure, secondary versus primary closure, loose closure, and negative pressure wound therapy. [11][12][13] While the bene ts of purse-string closure has demonstrated bene ts in reducing SSI following ostomy reversal, there are no current guidelines regarding the type of dressing used during the wound healing process, leading to wide variability amongst surgeons and institutions. The two randomized controlled trials comparing linear to purse-string closure do not describe any additional dressing for the purse-string closure patients.…”

Section: Discussionmentioning

confidence: 99%

“…16 A meta-analysis of studies utilizing negative pressure wound therapy for stoma closure demonstrated a reduction of SSIs but the conclusions are limited by the combination technique of several included studies where negative pressure was utilized in addition to purse-string closure. 12 The effect of iodine on stoma closure is even less well-known. Povidone-iodine is an antiseptic that has been used for more than a century.…”

Section: Discussionmentioning

confidence: 99%

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Infectious complications after modified purse-string stoma closure

Hao,

Bridges,

Sutton

et al. 2023

Preprint

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Purpose: Current society guidelines recommend purse-string closure technique for stoma reversal, which has been shown to reduce but not eliminate the risk of deep surgical site infection (SSI) at the original stoma site, a complication associated with increased morbidity and cost. We studied an adjunctive technique to further reduce the risk of SSI. Methods: A retrospective chart review was conducted on adult patients who underwent stoma reversal between May 2016 - July 2022. Stoma reversal was performed with purse-string closure, and placement of a strip of povidone-iodine soaked non-adherent pad in the remaining two cm opening at the prior stoma site. This pad was taken out on post-operative day one and changed to wet-to-dry saline moistened gauze. Results: 82 patients were identified. The cohort had a median BMI 26.5 [IQR 23.0-31.0] and median age 57.5 [IQR 45.8-67.0]. Mean time from original surgery to reversal was nine months. 59.8% identified as female, 24.4% were currently smoking, 18.3% were had diabetes. The cohort experienced a 11.0% readmission rate and 18.3% rate of stoma site hernia with a mean follow up of 17 months. No patient developed an SSI. Conclusion: In this cohort study with known risk factors for SSI, no patients undergoing stoma reversal experienced a post-operative SSI. The adjunctive technique of a povidone-iodine soaked non-adherent pad in addition to purse-string closure should be further examined in conjunction with surgical bundles to reduce the risk of SSI and overall morbidity of stoma reversal surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Infectious complications after modified purse-string stoma closure

Hao,

Bridges,

Sutton

et al. 2023

Preprint

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Virtual screening of FOXO3a activators from natural product-like compound library

et al. 2023

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Prophylactic negative pressure wound therapy to improve wound healing rates following ileostomy closure: a randomized controlled trial

Tiang,

Behrenbruch,

Noori

et al. 2024

ANZ Journal of Surgery

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BackgroundReversal of ileostomy is associated with morbidity including wound infection and prolonged wound healing. Negative pressure wound therapy (NPWT) has been shown to reduce time to wound healing by secondary intention. The aim of this study was to determine whether NPWT improved wound healing rates, compared with simple wound dressings, in patients undergoing reversal of ileostomy where the skin wound is closed with a purse‐string suture.MethodsThis was a dual‐centre, open‐label, randomized controlled trial with two parallel intervention arms. Patients undergoing elective loop ileostomy reversal were randomized 1:1 to receive NPWT or simple wound dressings. The primary endpoint of the study was assessment of complete wound healing at day 42 post reversal of ileostomy and the secondary endpoints were patient‐reported wound cosmesis using a visual analogue scale and rates of surgical site infection (SSI).ResultsThe study was conducted from June 2018 to December 2021. The trial was approved by the local ethics committee. We enrolled 40 patients, 20 in each arm. One patient in each arm was lost to follow up. Nine patients (9/19, 47.36%) in the simple dressing group had wound healing vs. 13 patients (13/19, 68.42%) in the NPWT group (P = 0.188). There was no significant difference in patient‐ reported wound cosmesis or SSI.ConclusionThere was no difference in wound healing rates when comparing NPWT to simple wound dressings at early and late time points post reversal of ileostomy, where the skin wound was closed with a purse‐string suture.

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Effect of Negative Pressure Wound Therapy on Surgical Site Infections following Stoma Reversal in Colorectal Surgery: A Meta-Analysis

Cited by 4 publications

References 47 publications

Infectious complications after modified purse-string stoma closure

Infectious complications after modified purse-string stoma closure

Virtual screening of FOXO3a activators from natural product-like compound library

Prophylactic negative pressure wound therapy to improve wound healing rates following ileostomy closure: a randomized controlled trial

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