Comparison of purse-string technique versus linear suture for skin closure after stoma reversal: a meta-analysis of high-quality studies
10.3393/ac.2025.00801.0114
- Author:
Filippo CARANNANTE
1
;
Guglielmo Niccolò PIOZZI
;
Gianluca COSTA
;
Valentina MIACCI
;
Gianfranco BIANCO
;
Vincenzo SCHIAVONE
;
Jim S. KHAN
;
Marco CARICATO
;
Gabriella Teresa CAPOLUPO
Author Information
1. Colorectal Surgery Clinical and Research Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Publication Type:Review
- From:Annals of Coloproctology
2025;41(6):491-500
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Stoma reversal is associated with notable postoperative morbidity. Several techniques exist for skin closure after stoma reversal, with linear primary closure (LC) and purse-string closure (PS) being the most common. This systematic review and meta-analysis aim to compare LC and PS skin closure after stoma reversal in terms of surgical site infection (SSI) rates, wound healing, and cosmesis.
Methods:In accordance with the PRISMA statement, a systematic review of skin closure after stoma reversal was conducted using MEDLINE (PubMed), Embase, Web of Science, and Scopus.
Results:Eleven studies, enrolling 1,052 patients (PS, n=534; LC, n=518), published between 2006 and 2024, were included. The overall quality of the studies was considered acceptable, with a mean Jadad scale score of 4 (range, 3–5). Patients underwent ileostomy or ileostomy/colostomy in 6 and 5 studies, respectively. No differences were observed between groups in operative time, length of hospital stay, intestinal obstruction, or incisional hernia. However, SSI and overall infection rates were higher in the LC group, with a statistically significant difference for SSI.
Conclusion:Skin closure following stoma reversal using the PS technique may offer advantages over LC. PS is associated with significantly lower SSI rates compared to LC. Although a large randomized controlled trial with long-term follow-up is still required, current findings suggest that PS could be considered the standard of care for wound closure after ileostomy reversal.
