European Journal of Molecular & Clinical Medicine

Abstract

Stoma is a surgically created intestinal opening on anterior abdominal wall. Its common forms include colostomy and ileostomy. History of stomas dates back to 1710 when Littre of Paris made first ventral colostomy for imperforate anus. After World War I a mortality rate of 60% due to primary repair of colonic injuries dropped to 30% in World War II due to the introduction of colostomy. Ileostomy gained popularity for ruptured appendix and appendicular abcess.
Aims: To compare the different methods of wound closure following stoma takedown in terms of superficial surgical site infection (SSI), to study other patient related factors like age, gender, nutritional status & other comorbidities which might be involved in developing complications at stoma takedown site and to study complications at stoma takedown site, other than SSSI, like abnormal wound healing & poor cosmesis, and their rates of occurrence in different wound closure methods.
Materials and Methods: This study was a prospective, observational, institution based, cross-sectional study. Ninety patients fulfilling the inclusion criteria and not having any exclusion criteria, from department of General Surgery of Bankura Sammilani Medical College and Hospital during the period of 1st November 2019 to 31st October 2020 were selected.
Result: In our study, patients with end colostomy (Hartmann’s procedure) have got the maximum count (22 out of 90; 24.44%), just followed by those with loop ileostomy (21 out of 90; 23.33%). Patients having loop or double barrel stoma (61 out of 90; 67.78%) had only one stoma-site post-operative wound as they didn’t require separate laparotomy for reversal. On the other hand, patients with end colostomy (Hartmann’s procedure) and end ileostomy with colonic mucous fistula at separate site (total 29 out of 90; 32.2%) required laparotomy for reversal.
Conclusion: It can be concluded that in a stoma takedown operation, use of purse-string technique during skin closure leads to decreased incidence of superficial surgical site infection at stoma closure site, in comparison to Linear primary suture & Delayed primary intention technique.