Role of subcutaneous closed suction drain in the prevention of incisional surgical site infection after loop ileostomy reversal with purse-string skin closure: a retrospective observational study

BMC Surg. 2024 Sep 9;24(1):252. doi: 10.1186/s12893-024-02549-2.

Abstract

Background: Surgical site infection (SSI) is not rare after loop ileostomy reversal. This study assessed the effects of a subcutaneous closed suction drain on reducing SSIs after loop ileostomy reversal with purse-string skin closure.

Methods: This retrospective study included 229 patients who underwent loop ileostomy reversal with purse-string closure at the Pusan National University Yangsan Hospital between January 2017 and December 2021. We divided the patients into those with a subcutaneous drain (SD group) and those without it (ND group). We analyzed variables that affected SSI occurrence in both groups.

Results: The SD and ND groups included 109 and 120 patients, respectively. The number of incisional SSIs was significantly lower in the SD than in the ND group (0 vs. 7 events). An average of 35.7 mL of fluid was collected in the drainage bulb during hospitalization. The C-reactive protein level on postoperative day 4 was significantly lower in the SD group than in the ND group. The insertion of a subcutaneous drain was the only factor associated with a reduced incidence of SSIs (p = 0.015).

Conclusions: Subcutaneous closed suction drain with purse-string skin closure in loop ileostomy reversal can reduce incisional SSI occurrence.

Keywords: Ileostomy reversal; Purse-string skin closure; Subcutaneous closed suction drain; Surgical site infection.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Drainage / methods
  • Female
  • Humans
  • Ileostomy* / methods
  • Male
  • Middle Aged
  • Reoperation
  • Retrospective Studies
  • Suction / methods
  • Surgical Wound Infection* / epidemiology
  • Surgical Wound Infection* / etiology
  • Surgical Wound Infection* / prevention & control
  • Suture Techniques