Purse-string versus linear for closure of the skin wound following stoma reversal: A meta-analysis with RCT and systematic review

Abstract

BackgroundLinear closure (LC) following stoma reversal have been reported to have a high risk of surgical site infection (SSI). Previous literature has shown that Purse-string closure (PSC) can effectively reduce the incidence of SSI. However, there are still a lack of evidence-based studies.Methods We conducted a search in Embase, PubMed, Web of Science, CNKI, Wanfang Database and VIP Chinese Sci-tech Journal Database, and conducted a randomized controlled experiment from early 2022 to February 2022. Among them, surgical site infection rate (SSI) within 30 days, operation time, hospitalization time, incisional hernia and wound healing time are all outcome indicators.Results A total of nine studies were included in this meta-analysis (441 patients in the purse-string closure group and 395 in the linear closure group). The pooled data showed the rate of SSI was statistically lower in the purse-string closure group than in the linear closure group (OR 0.14, 95% CI 0.08,0.24; p﹤0.00001; I2=0%). What is not statistically significant is the difference of operation time, hospitalization time, incision hernia and wound healing time.Conclusions PSC has a significantly lower rate of SSI following stoma reversal than LC.