Skin flap graft closure with modified negative pressure drainage: A new approach

Background : Stoma closure is linked to a high occurrence rate of surgical site infections, and the most suitable incision closure method is still a matter of debate. This study compared the short - and long - term outcomes between conventional linear incision closure (CLIC) and skin flap graft closure (SFGC) combined with modified negative pressure drainage in enterostomy for ileostomy reduction. Methods : Data were prospectively collected from 65 patients who underwent stoma closure by CLIC or SFGC at a single institution between January 2022 and December 2023. Twelve independent clinical variables, including sex, age, body mass index, smoking habits, history of cardiopulmonary disease, history of diabetes, preoperative hemoglobin level, preoperative albumin level, American Society of Anesthesiologists (ASA) score, primary disease, initial surgical treatment, and duration of surgery, were examined using univariate and multivariate analyses. Results : There was no significant difference in the median operative time between the two groups. However, the postoperative incision infection rate (24.2% vs. 3.1%; P = 0.035) and the median hospital stay (9 days vs. 14 days; P = 0.035) were significantly lower in the SFGC group than in the CLIC group. Conclusion : This study revealed that the main complications associated with stoma closure after CLIC were incisional infection. SFGC with modified negative pressure drainage is superior to CLIC, leading to fewer incisional infections, shorter hospital stays, and a more aesthetically pleasing abdominal shape.