Background: Circumferential subcuticular wound approximation (CSWA) of round shaped skin wounds after ileostomy take down is believed to lower the rates of surgical site infection (SSI). We performed this randomized trial to compare the rates of SSI and other short-term outcomes among primary linear skin closure (PC) and CSWA groups of patients. Patients and Methods: All patients undergoing ileostomy reversal during the study period were randomly assigned to either PC or CSWA. The primary outcome was the incidence of SSI as assessed by ASEPSIS scoring system. The secondary outcomes included healing time, length of post-operative hospital stay, and patients' satisfaction regarding cosmetic outcome, expectations, pain, time of healing, wound care, and activity on a five-point Likert scale. Results: Thirty-one patients (PC = 15; CSWA = 16) underwent ileostomy reversal during the study period. There was no SSI in the PC group whereas three patients developed SSI in the CSWA group but the result was not statistically significant (p = 0.23). The scores for time of healing (p < 0.001), wound care (p = 0.007), and activity (p < 0.001) were significantly better for PC compared with CSWA whereas there was no significant difference in the scores for cosmetic outcome, expectations, and pain. Healing time was shorter in the PC group (6.7 vs. 34.2 days; p < 0.001) whereas the post-operative length of stay was comparable (6.3 vs. 7 days; p = 0.27). Conclusions: Although there was no difference in the incidence of SSI among the two groups, the PC group fared better in terms of mean time to healing and requirement of wound care.

中文翻译：

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回肠造口闭合后伤口感染：比较初级与圆周皮下闭合技术的前瞻性随机研究的中期分析。

背景：回肠造口术拆除后圆形皮肤伤口的圆周皮下伤口近似（CSWA）被认为可以降低手术部位感染（SSI）的发生率。我们进行这项随机试验是为了比较初次线性皮肤闭合 (PC) 和 CSWA 组患者的 SSI 发生率和其他短期结局。患者和方法：研究期间所有接受回肠造口逆转的患者被随机分配至 PC 组或 CSWA 组。主要结局是通过 ASEPSIS 评分系统评估的 SSI 发生率。次要结局包括愈合时间、术后住院时间以及患者对美容效果、期望、疼痛、愈合时间、伤口护理和五点李克特量表活动的满意度。结果：31 名患者（PC = 15；CSWA = 16）在研究期间接受了回肠造口术逆转。PC 组没有出现 SSI，而 CSWA 组有 3 名患者出现 SSI，但结果没有统计学意义（p = 0.23）。与 CSWA 相比，PC 的愈合时间 (p < 0.001)、伤口护理 (p = 0.007) 和活动 (p < 0.001) 的评分明显更好，而美容效果、期望、和疼痛。PC 组的愈合时间较短（6.7 天与 34.2 天；p < 0.001），而术后住院时间相当（6.3 天与 7 天；p = 0.27）。结论：虽然两组之间 SSI 的发生率没有差异，但 PC 组在平均愈合时间和伤口护理需求方面表现更好。