Evidence news! A Cochrane review has been published investigating Purse‐string skin closure versus linear skin closure in people undergoing stoma reversal.

Objectives: To assess the effects of purse‐string skin closure compared with linear skin closure in people undergoing stoma reversal.

Main results: Nine trials with 757 participants were included.
Participants underwent elective reversal of either ileostomy (82%) or colostomy (18%). 

• Purse-string closure likely reduces the risk of surgical site infection compared with linear skin closure. The absolute risk of surgical site infection is 52 per 1000 people who have purse-string closure and 243 per 1000 people who have linear skin closure, moderate certainty evidence.
• People receiving a purse-string closure may have a higher likelihood of being very satisfied or satisfied with stoma closure compared with people who have linear skin closure, low certainty evidence.
• Regarding the risk of incisional hernia and operative time, purse-string closure compared with linear skin closure may have little or no effect, very low certainty evidence.

Authors' conclusion: People undergoing stoma-reversal likely have a reduced risk of surgical site infection, when the skin is closed with a purse-string closure, compared with linear skin closure, and people may be more satisfied with the result after purse-string closure. Regarding incisional hernia and operative time, there may be little to no differences between the two closure techniques, however, the evidence is very uncertain.

Access publication here: https://doi.org/10.1002/14651858.CD014763.pub2