Background:Surgical site infection(SSI)is the most common complication after stoma closure and is particularly common in obese patients.To reduce the incidence of SSI,various skin closure techniques have been proposed...Background:Surgical site infection(SSI)is the most common complication after stoma closure and is particularly common in obese patients.To reduce the incidence of SSI,various skin closure techniques have been proposed;however,the best technique is still under debate.The purpose of this study was to explore the effectiveness of subcutaneous vacuum drains(SVDs)after two surgical suture techniques following stoma reversal in obese patients. Methods:Data from 190 obese patients with rectal cancer who underwent stoma reversal for enterostomy between February 2012 and April 2023 at Jinxiang Hospital Affiliated to Jining Medical University were retrospectively analyzed.These patients were divided into two groups:gunsight suture(GS)with SVD and primary linear suture(PLS)with SVD.The GS group and PLS group included 90 and 100 patients,respectively.The clinical characteristics and short-term outcomes were compared between the two groups.Postoperative pain scores were analyzed using a generalized estimation equation. Results:Surgery was successfully performed in both groups.The rate of SSI in the GS group was significantly lower than that in the PLS group(2.2%vs 9.0%,P=0.046).Patients in the GS group had a significantly shorter wound healing time than did patients in the PLS group,as well as a significantly shorter postoperative fasting time(P<0.05).No significant differences were found between the groups in terms of the postoperative hospital stay,operative time,and estimated blood loss(P>0.05).The results of the generalized estimation equation analysis showed that the GS group had significantly lower pain scores at 12,24,48,and 72 h after surgery than the PLS group(P<0.05).Moreover,the GS group showed significantly better alleviation of wound pain between 12 and 72 h after surgery(P<0.05). Conclusions:The GS technique with SVD may be recommended for wound closure of a nonfunctioning stoma in obese patients.展开更多
Background:Surgical-site infection(SSI)was one of the most common post-operative morbidities of ileostomy reversal.Although several skin-closure procedures had been developed to reduce the rate of SSI,the optimal proc...Background:Surgical-site infection(SSI)was one of the most common post-operative morbidities of ileostomy reversal.Although several skin-closure procedures had been developed to reduce the rate of SSI,the optimal procedure remains unclear.In this study,we compared the effect of two surgical techniques for wound closure following ileostomy reversal:gunsight suture(GS)and linear suture(LS).Methods:A total of 233 patients who underwent loop ileostomy at the Sixth Affiliated Hospital of Sun Yat-sen University between January 2015 and December 2017 were enrolled into our study.These patients were divided into two groups:the LS group and the GS group.We compared the clinical characteristics between the two groups and analyzed the data using IBM SPSS to identify risk factors for SSI.Results:Both groups successfully underwent surgery.The rate of SSI was significantly lower in the GS group(n=2,0.02%)than in the LS group(n=16,12.00%,P=0.007).The length of hospital stay after the operation in the GS group was significantly shorter than that in the LS group(8.163.2 vs 10.865.4 days,P<0.001).Multivariate analysis showed that GS was an independent protective risk factor for SSI(odds ratio=0.212,P=0.048).Conclusions:Compared with the LS technique,the GS technique can significantly decrease the rate of SSI and shorten the length of hospital stay after surgery.The GS technique may be recommended for wound closure following ileostomy reversal.展开更多
基金supported by the New Technology and New Project of Jinxiang Hospital Affiliated to Jining Medical University(No.JY2021022).
文摘Background:Surgical site infection(SSI)is the most common complication after stoma closure and is particularly common in obese patients.To reduce the incidence of SSI,various skin closure techniques have been proposed;however,the best technique is still under debate.The purpose of this study was to explore the effectiveness of subcutaneous vacuum drains(SVDs)after two surgical suture techniques following stoma reversal in obese patients. Methods:Data from 190 obese patients with rectal cancer who underwent stoma reversal for enterostomy between February 2012 and April 2023 at Jinxiang Hospital Affiliated to Jining Medical University were retrospectively analyzed.These patients were divided into two groups:gunsight suture(GS)with SVD and primary linear suture(PLS)with SVD.The GS group and PLS group included 90 and 100 patients,respectively.The clinical characteristics and short-term outcomes were compared between the two groups.Postoperative pain scores were analyzed using a generalized estimation equation. Results:Surgery was successfully performed in both groups.The rate of SSI in the GS group was significantly lower than that in the PLS group(2.2%vs 9.0%,P=0.046).Patients in the GS group had a significantly shorter wound healing time than did patients in the PLS group,as well as a significantly shorter postoperative fasting time(P<0.05).No significant differences were found between the groups in terms of the postoperative hospital stay,operative time,and estimated blood loss(P>0.05).The results of the generalized estimation equation analysis showed that the GS group had significantly lower pain scores at 12,24,48,and 72 h after surgery than the PLS group(P<0.05).Moreover,the GS group showed significantly better alleviation of wound pain between 12 and 72 h after surgery(P<0.05). Conclusions:The GS technique with SVD may be recommended for wound closure of a nonfunctioning stoma in obese patients.
基金supported by the Guangzhou Science and Technology Plan Project[No.201704020059 and 201803010074]National Key Clinical Discipline.
文摘Background:Surgical-site infection(SSI)was one of the most common post-operative morbidities of ileostomy reversal.Although several skin-closure procedures had been developed to reduce the rate of SSI,the optimal procedure remains unclear.In this study,we compared the effect of two surgical techniques for wound closure following ileostomy reversal:gunsight suture(GS)and linear suture(LS).Methods:A total of 233 patients who underwent loop ileostomy at the Sixth Affiliated Hospital of Sun Yat-sen University between January 2015 and December 2017 were enrolled into our study.These patients were divided into two groups:the LS group and the GS group.We compared the clinical characteristics between the two groups and analyzed the data using IBM SPSS to identify risk factors for SSI.Results:Both groups successfully underwent surgery.The rate of SSI was significantly lower in the GS group(n=2,0.02%)than in the LS group(n=16,12.00%,P=0.007).The length of hospital stay after the operation in the GS group was significantly shorter than that in the LS group(8.163.2 vs 10.865.4 days,P<0.001).Multivariate analysis showed that GS was an independent protective risk factor for SSI(odds ratio=0.212,P=0.048).Conclusions:Compared with the LS technique,the GS technique can significantly decrease the rate of SSI and shorten the length of hospital stay after surgery.The GS technique may be recommended for wound closure following ileostomy reversal.
