Purpose: Surgical site infection (SSI) is one of the most frequent complications after stoma closure and the optimal skin closure technique is still not clear. The goal of this review was to compare outcomes with purse-string closure technique (PSC) versus conventional closure technique (CCT) for skin closure after stoma reversal. Methods: We performed a systematic review and meta-analysis of available randomized controlled trials (RCTs) to compare SSI rate within 30 days, operative time, hospital stay, incisional hernia and intestinal obstruction rates between PSC and CCT. Results: The pooled analysis of 5 studies showed a statically significant lower rate of SSI in favor of PSC compared to CCT (OR -0.24; 95% CI -0.32, - 0.15; p < 0.00001). No statistically significant differences were observed in the operative time (OR -0.05; 95% CI -3.95, 3.84; p = 0.98) and in the length of hospital stay (OR -0.20; 95% CI -0.76, 0.36; p = 0.48), between the two techniques. Additionally, two out of the five studies provided data on incisional hernia and intestinal obstruction and the pooled analysis revealed no statistically significant differences between PSC and CCT techniques: incisional hernia (OR 0.81, 95% CI 0.27–2.47; p = 0.71) and intestinal obstruction (OR 1.07, 95% CI 0.41–2.84; p = 0.88). Conclusions: The analysis of 5 RCTs showed that SSI rate is statistically significant lower when PSC is performed, compared to CCT. Whereas, no significant differences were found between the two techniques with regards to operative time, length of hospital stay, incisional hernia and intestinal obstruction rates.

Purse-string closure versus conventional primary closure of wound following stoma reversal: Meta-analysis of randomized controlled trials / Rondelli, Fabio; Franco, Laura; Balzarotti Canger, Ruben Carlo; Ceccarelli, Graziano; Becattini, Cecilia; Bugiantella, Walter. - In: INTERNATIONAL JOURNAL OF SURGERY. - ISSN 1743-9191. - 52:(2018), pp. 208-213. [10.1016/j.ijsu.2018.02.027]

Purse-string closure versus conventional primary closure of wound following stoma reversal: Meta-analysis of randomized controlled trials

Franco, Laura;Ceccarelli, Graziano;
2018

Abstract

Purpose: Surgical site infection (SSI) is one of the most frequent complications after stoma closure and the optimal skin closure technique is still not clear. The goal of this review was to compare outcomes with purse-string closure technique (PSC) versus conventional closure technique (CCT) for skin closure after stoma reversal. Methods: We performed a systematic review and meta-analysis of available randomized controlled trials (RCTs) to compare SSI rate within 30 days, operative time, hospital stay, incisional hernia and intestinal obstruction rates between PSC and CCT. Results: The pooled analysis of 5 studies showed a statically significant lower rate of SSI in favor of PSC compared to CCT (OR -0.24; 95% CI -0.32, - 0.15; p < 0.00001). No statistically significant differences were observed in the operative time (OR -0.05; 95% CI -3.95, 3.84; p = 0.98) and in the length of hospital stay (OR -0.20; 95% CI -0.76, 0.36; p = 0.48), between the two techniques. Additionally, two out of the five studies provided data on incisional hernia and intestinal obstruction and the pooled analysis revealed no statistically significant differences between PSC and CCT techniques: incisional hernia (OR 0.81, 95% CI 0.27–2.47; p = 0.71) and intestinal obstruction (OR 1.07, 95% CI 0.41–2.84; p = 0.88). Conclusions: The analysis of 5 RCTs showed that SSI rate is statistically significant lower when PSC is performed, compared to CCT. Whereas, no significant differences were found between the two techniques with regards to operative time, length of hospital stay, incisional hernia and intestinal obstruction rates.
2018
Conventional closure; Incisional hernia; Intestinal obstruction; Purse-string suture or closure; Surgical site infection; Humans; Incisional Hernia; Intestinal Obstruction; Length of Stay; Operative Time; Randomized Controlled Trials as Topic; Surgical Wound Infection; Wound Closure Techniques; Surgical Stomas; Surgery
01 Pubblicazione su rivista::01a Articolo in rivista
Purse-string closure versus conventional primary closure of wound following stoma reversal: Meta-analysis of randomized controlled trials / Rondelli, Fabio; Franco, Laura; Balzarotti Canger, Ruben Carlo; Ceccarelli, Graziano; Becattini, Cecilia; Bugiantella, Walter. - In: INTERNATIONAL JOURNAL OF SURGERY. - ISSN 1743-9191. - 52:(2018), pp. 208-213. [10.1016/j.ijsu.2018.02.027]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1194994
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