Impact of different skin suturing methods on patient prognosis after ileostomy closure

不同皮肤缝合方法对回肠造口术后患者预后的影响

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Abstract

BACKGROUND: At present, prophylactic ileostomy is commonly used to protect distal intestinal anastomoses, particularly during the recovery period following colorectal surgery. However, after the ileum is returned to the abdominal cavity, abdominal closure using traditional vertical interrupted suturing is associated with a higher incidence of wound infections. For patients undergoing ileostomy closure, selecting an appropriate suturing method for the skin incision at the stoma site is crucial for improving patient prognosis. AIM: To investigate the impact of three different skin suturing methods at the ileostomy closure site on patient prognosis. METHODS: Thirty patients who underwent ileostomy closure at the Affiliated Hospital of Qinghai University between January 2024 and October 2024 were selected based on inclusion and exclusion criteria. The patients were divided into three groups: The purse-string suture group, the cross-suture group, and the vertical interrupted suture group, with 10 cases in each group. The purse-string suture group, cross-suture group, and vertical interrupted suture group used purse-string, cross, and vertical interrupted suturing methods, respectively, for the skin incision at the ileostomy closure site. RESULTS: There were no statistically significant differences among the three groups in terms of operative time, intraoperative blood loss, time to resume liquid diet, time to first bowel movement, postoperative hospital stay, hospitalization costs, or levels of white blood cell count, hemoglobin, and albumin on the third postoperative day (P > 0.05). Nevertheless, significant differences (P < 0.05) were observed in incision suture removal time, wound healing time, C-reactive protein levels on the third postoperative day, visual analog scale pain scores during the first three postoperative days, and the incidence of surgical site infection. Overall, the therapeutic outcomes of the purse-string suture group and the cross-suture group were superior to the vertical interrupted suture group. CONCLUSION: Using purse-string or cross-suturing methods for skin incision at the ileostomy closure site can shorten wound healing and suture removal times, reduce surgical site infection incidence and postoperative inflammatory response, alleviate incision pain, and promote rapid postoperative recovery.

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