Journal Article

Delayed Primary Skin Closure Followed by Single-use Negative-pressure Wound Therapy Is Optimal for Wound Management After Bowel-stoma Reversal

TERASHIMA, KAZUTOSHI, KASAJIMA, HIROYUKI, UMEHARA, MINORU, YAMANA, DAISUKE, IMAIZUMI, KEN, FUKASAWA, TAKUMU, FURUKAWA, NAOE, ODAGIRI, TADASHI, KURUSHIMA, MICHIHIRO, ITO, KEIICHIRO, TSURUGA, YOSUKE, NAKANISHI, KAZUAKI

2025

Overview

Although the purse-string suture (PSS) method is widely adopted to reduce surgical-site infection (SSI; the commonest complication following bowel-stoma closure), this technique is associated with delayed epithelialization. Recently, delayed primary closure (DPC) combined with negative-pressure wound therapy (NPWT) has been proposed as a promising alternative. This study aimed to evaluate the clinical efficacy of DPC with NPWT compared to the PSS method in stoma-closure surgery. We conducted a retrospective observational study involving 31 patients who underwent stoma closure between January 2021 and March 2023. Patients were categorized into two groups: PSS with or without NPWT (PSS±NPWT; n=15) and DPC with NPWT (DPC+NPWT; n=16). The primary outcome was wound-healing duration; the secondary outcomes were patient satisfaction and in-hospital costs. The wound-healing duration was significantly shorter in the DPC+NPWT group compared to the PSS±NPWT group (median: 20 45 days, <0.001). Multivariate analysis identified wound-closure method as an independent predictor of wound healing at 30 days. Patient-reported outcomes indicated improved wound-care experience and a trend toward better cosmetic satisfaction in the DPC+NPWT group. Although not statistically significant, the total in-hospital costs were lower in the DPC+NPWT group despite higher device-related expenditures. DPC with NPWT significantly shortened the wound-healing duration and showed potential benefits regarding patient satisfaction and healthcare costs compared to the PSS method. These findings suggest DPC with NPWT as a viable alternative for bowel-stoma closure and wound management.

• Publisher: International Institute of Anticancer Research
• Subject: Abdomen / Adult / Aged / Diabetes / Female / Hospital costs / Humans / Male / Methods / Middle Aged / Negative-Pressure Wound Therapy - methods / Ostomy / Patient satisfaction / Questionnaires / Retrospective Studies / Skin / Steroids / Surgeons / Surgery / Surgical anastomosis / Surgical outcomes / Surgical Stomas - adverse effects / Surgical Wound Infection - etiology / Surgical Wound Infection - prevention & control / Suture Techniques / Sutures / Treatment Outcome / Wound Closure Techniques / Wound Healing