scholarly journals The technique for less infectious and earlier healing of stoma closure wound: negative pressure wound therapy with instillation and dwelling followed by primary closure

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoshinori Yane ◽  
Jin-ichi Hida ◽  
Yusuke Makutani ◽  
Hokuto Ushijima ◽  
Yasumasa Yoshioka ◽  
...  

Abstract Background Temporary stomas have been widely used to avoid the risk of complications such as anastomotic leakage after colorectal resection. Stoma closure is relatively easy; however, postoperative surgical site infection (SSI) may be a problem. Various methods have been used to reduce the incidence of SSI. We aimed to evaluate a new technique for stoma wound closure. Methods We enrolled patients who underwent stoma closure at our hospital between September 2019 and May 2020. We selected patients who lived far from our hospital and had difficulty visiting the hospital regularly and who agreed to undergo this surgical technique. We used negative pressure wound therapy with instillation and dwelling (NPWTi-d) and delayed primary closure for these patients. Results Four patients underwent NPWTi-d and delayed primary closure without the occurrence of SSI. The median postoperative hospital stay was 9 days (range: 7–14 days), and the median number of days to confirmation of epithelialization was 11.5 days (range: 10–16 days). Conclusion The combined use of NPWTi-d and delayed primary closure for the stoma wound was very effective. This method may be a valuable new technique for wound management after stoma closure.

2021 ◽  
Author(s):  
Yoshinori Yane ◽  
Jin-ichi Hida ◽  
Yasutaka Chiba ◽  
Yusuke Makutani ◽  
Hokuto Ushijima ◽  
...  

Abstract The use of temporary diverting stoma has become more common in low colorectal anastomosis to reduce anastomotic complications. Surgical site infection (SSI) at the stoma closure site has been one of the most frequent postoperative complications. The aim of this study was to compare the short-term outcomes between conventional primary suture closure and negative pressure wound therapy with instillation and dwelling (NPWTi-d) therapy following purse-string suturing, using propensity score matching analysis. We retrospectively evaluated the medical records of 107 patients who underwent stoma closure between January 2016 and October 2020. The primary outcome was the proportion of SSI. The secondary outcome was the day of postoperative length of stay. Propensity score matching with one-to-one match was performed for reducing treatment selection bias. Of a total of 107 patients, 67 patients had been treated with conventional primary closure and 40 with NPWTi-d therapy. The propensity score matching derived 37 pairs. The respective SSI proportions were 0% and 16.2% in the groups with NPWTi-d and primary closure (P=0.025). The respective median days of postoperative hospital stay were 9.0 and 10.0 in the groups with NPWTi-d and primary closure (P=0.453). NPWTi-d therapy with purse-string suturing was effective in reducing SSI after stoma closure.


2018 ◽  
Vol 71 (4) ◽  
pp. 173-176
Author(s):  
Atsushi Naito ◽  
Kohei Murata ◽  
Yoshinori Kagawa ◽  
Kenji Kawai ◽  
Ryuichi Kuwahara ◽  
...  

Redox Biology ◽  
2019 ◽  
Vol 20 ◽  
pp. 307-320 ◽  
Author(s):  
Gregory Lucien Bellot ◽  
Xiaoke Dong ◽  
Amitabha Lahiri ◽  
Sandeep Jacob Sebastin ◽  
Ines Batinic-Haberle ◽  
...  

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