Ann Surg Treat Res.  2023 Sep;105(3):126-132. 10.4174/astr.2023.105.3.126.

The effectiveness of negative-pressure wound therapy for wound healing after stoma reversal: a randomized control study

• Kang SI
• Kim S

• KMID: 2545903
• DOI: http://doi.org/10.4174/astr.2023.105.3.126

Abstract

Purpose
The purse-string closure (PSC) method is used for skin closure after stoma reversal to reduce surgical site infections (SSIs). However, PSC requires a longer healing period than primary closure. The application of negativepressure wound therapy (NPWT) may reduce the healing period of many wound types. This study aimed to investigate whether the application of NPWT promotes wound healing after the PSC method for stoma reversal.
Methods
This study was a randomized controlled study. Patients who had undergone stoma reversal surgery were randomized to receive NPWT or simple dressing after surgery. The primary outcome was a complete wound-healing period. We also investigated SSI, hospital stay, total cost, and the patient and observer scar assessment scale (POSAS) as secondary outcomes.
Results
A total of 36 patients were randomized into 2 groups. The median wound healing period was shorter in the NPWT group than in the control group (17.5 days [range, 11–24 days] vs. 21.5 days [range, 14–41 days], P = 0.006). SSI rate and hospital stay did not differ between the groups. However, the number of dressings was lower in the NPWT group than in the control group (5 [range, 3–7] vs. 17 [range, 10–30], P < 0.001). The total cost for dressing was comparable between the groups. The POSAS was not different between the groups.
Conclusion
This study revealed that NPWT application after PSC for stoma reversal site is effective in reducing the wound healing period compared to simple dressing, without increasing SSI and total cost.

Keyword

Colostomy; Ileostomy; Negative-pressure wound therapy

Figure

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  Fig. 1 (A) Control group, simple transparent dressing. (B) Experimental group, negative-pressure wound therapy dressing.

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  Fig. 2 A case of complete wound healing.

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  Fig. 3 Consolidated Standards of Reporting Trials (CONSORT) diagram. ASA, American Society of Anesthesiologists; PS, physical status; NPWT, negative-pressure wound therapy.

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  Fig. 4 Complete wound healing period between the control and negative-pressure wound therapy (NPWT) groups.

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