Abstract: ObjectiveTo improve the design of operative incision in stoma closure and to further evaluate the value of newly diamond incision.MethodsThe clinical data of 5 cases performed stoma closure from December 2016 to March 2017 were analyzed retrospectively. Taking two points, marked as A or C, which are about 1 centimeter distant from the edge of the fistula. The line AC was perpendicular to the abdominal dermatoglyphs, and pass through the center of original fistula. Another two points, marked as B or D, were closed to the edge of the fistula. The line BD was paralleled to dermatoglyphs. Connecting four points into a diamond -ABCD with the long diagonal of 4 to 5 centimeters and short diagonal of 2 to 3 centimeters. Join the mid-points on each side of the diamond-ABCD by a needle, then, tighten the cut into a cross, indwelling gram size pore in the middle against the subcutaneous drainage.ResultsThe operative time of stoma closure was 65 to 115 minutes with an average of 90 minutes in all 5 cases. No serious post-operative complications such as severe pain, incisional hernia and superficial incisional surgical site infection (SSI) were found.ConclusionThe diamond incision can be superior to the conventional fusiform incision with simple operating, lower SSI, less pain and better cosmetic result.
袁园园，刘刚磊，王沙龙，袁联文. 改进菱形切口在回肠造口关瘘术中的应用[J]. 中国现代手术学杂志, 2017, 21(4): 261-264.
YUAN Yuan-yua. The Clinical Value of Newly Diamond Incision in Stoma Closure. Chinese Journal of Modern Operative Surgery, 2017, 21(4): 261-264.
Kobayashi S, Ito M, Sugito M, et al. Association between incisional surgical site infection and the type of skin closure after stoma closure[J]. Surg Today, 2011, 41(7):941-945. doi: 10.1007/s00595-010-4405-y. |
[3]
Reinforcement of Closure of Stoma Site (ROCSS) Collaborative and the West Midlands Research Collaborative. Feasibility study from a randomized controlled trial of standard closure of a stoma site vs biological mesh reinforcement[J]. Colorectal Dis, 2016, 18(9):889-896. doi: 10.1111/codi.13310. |
[4]
Edwards DP, Leppington-Clarke A, Sexton R, et al. Stoma-related complications are more frequent after transverse colostomy than loop ileostomy: a prospective randomized clinical trial[J]. Br J Surg, 2001, 88(3):360-363. |
[5]
杨春明主编. 实用普通外科手术学[M]. 北京：人民卫生出版社， 2014. |
[6]
Hackam DJ, Rotstein OD. Stoma closure and wound infection: an evaluation of risk factors[J]. Can J Surg, 1995, 38(2):144-148. |
[7]
Wong KS, Remzi FH, Gorgun E, et al. Loop ileostomy closure after restorative proctocolectomy: outcome in 1,504 patients[J]. Dis Colon Rectum, 2005, 48(2):243-250. |
Semsarzadeh NN, Tadisina KK, Maddox J, et al. Closed Incision negative-pressure therapy is associated with decreased surgical-site infections: A Meta-analysis[J]. Plast Reconstr Surg, 2015, 136(3):592-602. doi: 10.1097/PRS.0000000000001519. |
[10]
Wada Y, Miyoshi N, Ohue M, et al. Comparison of surgical techniques for stoma closure: A retrospective study of purse-string skin closure versus conventional skin closure following ileostomy and colostomy reversal[J]. Mol Clin Oncol, 2015, 3(3):619-622.
2017, Vol. 21 
