Clinical Trials Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2025; 17(7): 106560
Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.106560
Impact of different skin suturing methods on patient prognosis after ileostomy closure
Yu-Bo Gao, Liang Wang, Li-Na Shi, Xiao Wu, Wei Miao
Yu-Bo Gao, Graduate School of Qinghai University, Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Liang Wang, Li-Na Shi, Wei Miao, Department of Gastrointestinal Oncology Surgery, Affiliated Hospital of Qinghai University, Xining 810000, Qinghai Province, China
Xiao Wu, Qinghai University, Xining 810000, Qinghai Province, China
Co-first authors: Yu-Bo Gao and Liang Wang.
Author contributions: Gao YB and Wang L contributed equally as co-first authors; Miao W contributed to the study concept and design, revised and reviewed the manuscript; Gao YB, Wang L, and Shi LN wrote the manuscript; Wu X collected the data; Gao YB reviewed the literature; Wang L was responsible for the data analysis and making figure; Miao W is the guarantor of this study; and all authors contributed to the article and approved the submitted version.
Institutional review board statement: The study was reviewed and approved by the Affiliated Hospital of Qinghai University Institutional Review Board (No. SL-2023170).
Clinical trial registration statement: As the author’s organization and ethics committee did not require clinical trial registration prior to the study, this study was not registered.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The raw data supporting the conclusions of this article will be made available by the authors without undue reservation.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Miao, Chief Physician, Professor, Department of Gastrointestinal Oncology Surgery, Affiliated Hospital of Qinghai University, No. 29 Tongren Road, Xining 810000, Qinghai Province, China. mwgg.711@163.com
Received: March 3, 2025
Revised: April 3, 2025
Accepted: May 30, 2025
Published online: July 27, 2025
Processing time: 144 Days and 21.5 Hours
Abstract
BACKGROUND

At present, prophylactic ileostomy is commonly used to protect distal intestinal anastomoses, particularly during the recovery period following colorectal surgery. However, after the ileum is returned to the abdominal cavity, abdominal closure using traditional vertical interrupted suturing is associated with a higher incidence of wound infections. For patients undergoing ileostomy closure, selecting an appropriate suturing method for the skin incision at the stoma site is crucial for improving patient prognosis.

AIM

To investigate the impact of three different skin suturing methods at the ileostomy closure site on patient prognosis.

METHODS

Thirty patients who underwent ileostomy closure at the Affiliated Hospital of Qinghai University between January 2024 and October 2024 were selected based on inclusion and exclusion criteria. The patients were divided into three groups: The purse-string suture group, the cross-suture group, and the vertical interrupted suture group, with 10 cases in each group. The purse-string suture group, cross-suture group, and vertical interrupted suture group used purse-string, cross, and vertical interrupted suturing methods, respectively, for the skin incision at the ileostomy closure site.

RESULTS

There were no statistically significant differences among the three groups in terms of operative time, intraoperative blood loss, time to resume liquid diet, time to first bowel movement, postoperative hospital stay, hospitalization costs, or levels of white blood cell count, hemoglobin, and albumin on the third postoperative day (P > 0.05). Nevertheless, significant differences (P < 0.05) were observed in incision suture removal time, wound healing time, C-reactive protein levels on the third postoperative day, visual analog scale pain scores during the first three postoperative days, and the incidence of surgical site infection. Overall, the therapeutic outcomes of the purse-string suture group and the cross-suture group were superior to the vertical interrupted suture group.

CONCLUSION

Using purse-string or cross-suturing methods for skin incision at the ileostomy closure site can shorten wound healing and suture removal times, reduce surgical site infection incidence and postoperative inflammatory response, alleviate incision pain, and promote rapid postoperative recovery.

Keywords: Ileostomy closure; Purse-string suture; Cross-suture; Vertical interrupted suture; Surgical site infection

Core Tip: For patients undergoing ileostomy closure, selecting an appropriate suturing method for the skin incision at the stoma site is crucial for improving patient prognosis. Using purse-string or cross-suturing methods for skin incision can shorten wound healing and suture removal times, reduce surgical site infection incidence and postoperative inflammatory response, alleviate incision pain, and promote rapid postoperative recovery. These two suturing methods are recommended for further clinical application.