The following is a summary of “Risk factors for surgical site infections and trends in skin closure technique after diverting loop ileostomy reversal: A multi-institutional analysis,” published in the November 2023 issue of Surgery by Mirande, et al.
Surgical site infections (SSIs) pose a common complication after diverting loop ileostomy (DLI) closures. For a retrospective study spanning 2012 to 2021 across a multistate health system, researchers sought to evaluate SSIs post-DLI closure and discern temporal trends in skin closure techniques.
Utilizing the American College of Surgeons National Surgical Quality Improvement Program database, adult patients undergoing DLI closure were analyzed. Skin closure techniques were categorized as primary, primary + drain, or purse-string closure. The primary outcome focused on SSIs at the former DLI site.
Of the patients, 5.7% experienced SSIs, with 6.9%, 5.7%, and 2.7% rates for primary closure, primary closure + drain, and purse-string closure, respectively (P = 0.25). Crohn’s disease, diverticular disease, and prolonged operative time were identified as significant risk factors for SSIs. A notable increasing trend in purse-string closure usage was observed over time (P < 0.0001).
The investigation revealed a relatively low SSI rate following DLI closure, exhibiting no significant variation based on the skin closure technique employed. Noteworthy was the escalating adoption of purse-string closure over the years. The study shed light on risk factors associated with SSIs, providing valuable insights for enhancing postoperative care strategies.
Reference: americanjournalofsurgery.com/article/S0002-9610(23)00375-6/fulltext
