Complications of Purse-String Closure Technique Vs Linear Closure in Patients with Stoma
Authors:   Médico Residente de Cirugía General, Hospital General Regional No. 1 Orizaba, Veracruz México, OOAD Veracruz Sur del Instituto Mexicano del Seguro Social. México., Gallegos Esperanza Guadalupe Carlock , Mollinedo Valeria Ailyn Cortés ,   Médico Residente de Cirugía General, Hospital General Regional No. 1 Orizaba, Veracruz México, OOAD Veracruz Sur del Instituto Mexicano del Seguro Social. México., Flores Ariana Citlalli Martínez ,   Médico Adscrito de Cirugía de Colon y Recto, Hospital General Regional No. 1 Orizaba, Veracruz México, OOAD Veracruz Sur del Instituto Mexicano del Seguro Social. México., Kristel Rodriguez García Karina ,   Médico Residente de Cirugía General, Hospital General Regional No. 1 Orizaba, Veracruz México, OOAD Veracruz Sur del Instituto Mexicano del Seguro Social. México., Reynoso Ernesto Alejandro Zavala ,   Médico Adscrito de Cirugía General, Hospital General Regional No. 1 Orizaba, Veracruz México, OOAD Veracruz Sur del Instituto Mexicano del Seguro Social. México.
Published: December 2024

Background: A variety of surgical techniques have been proposed for abdominal wall closure in patients with stoma with the aim of reducing the incidence of surgical site infection. However, the ideal skin closure technique has not yet been determined. Surgical site infection was one of the most common postoperative morbidities of ileostomy and colostomy reversal and although several skin closure procedures have been developed to reduce the rate of surgical site infection and its associated comorbidities, the incidence rates nationally and internationally range between 2% and 41% and it has been reported that it can increase costs, prolong hospitalization time and affect the patient's quality of life.

Objetive: To compare the tabaco closure technique vs. linear closure in patients with stoma at the Regional General Hospital 01.

Materials and methods: Observational, analytical, retrospective study, information was collected from both outpatient and hospital records of patients with a stoma during the period 2022-2024, the evolution after stoma closure, its main post-surgical complications, type of wall closure technique, comorbidities, days of hospitalization and days of antimicrobial therapy. The data obtained were analyzed together with a methodological advisor in a specially created database and for statistical analysis, SPSS was used to create result graphs, as well as descriptive statistics.

Results: According to the inclusion criteria the total sample was 25 participants, the average age was 50.9 years predominating in the age range 51-66 years, according to sex with a higher frequency male 15 (60%), Regarding the type of stoma in greater presentation was the colostomy 13 (52%) and according to the technique used for stoma closure we found tobacco pouch 13 (52%) and linear 12 (48%) it was identified regarding the tobacco pouch technique did not have any complications in 11 (44%), in 2 (8%) presented dehiscence and regarding the linear technique 5 (20%) presented incisional hernia, followed by dehiscence 3 (12%), infection 2 (8%) and 2 (8%) presented no complications. According to statistical analysis SPSS Pearson Chi-Square was reported a value of 13.412 with significance p = 0. 004 for the association of the tobacco pouch technique and linear technique with complications..

Conclusion: The tabaco purse technique had fewer complications compared to the linear technique