![]() ![]() ![]() Since then, NPWT has been applied to various types of wounds worldwide, and numerous studies have shown its effectiveness in reducing the SSI rate and promoting wound healing. Negative-pressure wound therapy (NPWT) was first introduced in 1997. Specifically, the mean wound-healing time is 2 weeks in patients who undergo primary closure of the skin and do not develop an SSI, but is 3.8 weeks in patients who undergo PSC after stoma reversal. Thus, a disadvantage of PSC is that the wound-healing period is prolonged compared to that for primary closure. However, a hole 0.5–1 cm in diameter is formed during the PSC method for discharge drainage, and secondary healing of this skin hole is induced. Thus, the SSI rate decreases dramatically when PSC is used for skin closure after stoma reversal. Furthermore, a meta-analysis of four RCTs reported significantly fewer instances of SSI with PSC than with conventional primary closure (risk difference, − 0.25 95% confidence interval, − 0.36 to − 0.15 p < 0.00001). In two previous randomised control trials (RCTs), the SSI rate was lower in patients who underwent PSC after stoma reversal than in those who underwent conventional linear closure after stoma reversal (0% vs 36.1% and 2% vs 15%, respectively). The purse-string closure (PSC) method was developed in an effort to reduce the rate of SSI at the stoma reversal site, and is now widely used for skin closure after stoma reversal surgery (Fig. Indeed, the incidence of SSI in cases of primary closure of the skin after stoma reversal is as high as 40%. Stoma site closure is generally classified as a class 3, clean-contaminated wound, which has a high risk of SSI. However, stoma reversal surgery has various complications, with the most common being surgical site infection (SSI). Patients with a temporary stoma generally undergo reversal surgery a few weeks to several months later. Surgeons form temporary stomas to prevent disastrous complications due to anastomotic leakage after colorectal resection, or to maintain bowel continuity in challenging cases of emergency bowel surgery. Trial registrationĬlinical Research Information Service (CRIS), KCT0004063. The results of this planned randomised controlled study will clarify the role of NPWT in patients undergoing stoma reversal and strengthen the rationale for choosing a dressing technique. Secondary endpoints will be the SSI rate, length of postoperative hospital stay, number of wound dressings and visits to the hospital for wound dressing after discharge, total cost of wound dressings, and patient and observer scar assessment scale scores. The primary endpoint will be the duration to wound healing, defined as the time to nearly complete epithelisation of the wound, without any discharge or surgical site infection (SSI). The target sample size will be 38 patients, as this will provide 80% power at the 5% level of significance to detect a 7-day reduction in the wound-healing period in the intervention group compared to that in the control group. Patients in the control group will receive standard postsurgical wound care patients in the intervention group will receive NPWT using the PICO™ system. Patients undergoing stoma reversal will be recruited and allocated into intervention and control groups, with 1:1 randomisation. Herein, we describe a planned trial to test the hypothesis that NPWT can reduce the healing period for PSC after stoma reversal. The application of negative-pressure wound therapy (NPWT) can reduce the healing period for many types of wounds. Although the wound-healing period for purse-string closure (PSC) after stoma reversal is longer than that required for the primary closure method, the rate of wound infection is reduced. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |