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World Journal of Surgery
Published in: World Journal of Surgery 7/2019

01-07-2019 | Ileostomy | Original Scientific Report

The Effectiveness of Contralateral Drainage in Reducing Superficial Incisional Surgical Site Infection in Loop Ileostomy Closure: Prospective, Randomized Controlled Trial

Authors: Anna Serracant, Xavier Serra-Aracil, Laura Mora-López, Anna Pallisera-Lloveras, Sheila Serra-Pla, Alba Zárate-Pinedo, Salvador Navarro-Soto

Published in: World Journal of Surgery | Issue 7/2019

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Abstract

Background

Loop ileostomy reduces the rates of morbidity due to colorectal anastomotic dehiscence. For its part, ileostomy closure is associated with low mortality (0–4%) but substantial morbidity (11–37%). Incisional surgical site infection (SSI) is one of the most frequent complications (2–40%).

Methods

A single-center, prospective, randomized controlled clinical trial of two study groups: control (conventional primary skin closure) and experimental (primary skin closure with a contralateral Penrose® drain).

Results

Seventy patients undergoing loop ileostomy closure between April 2013 and June 2017 were included (35 per branch). Four were later removed from the study. Six of the remaining 66 patients (per protocol analysis) were diagnosed with incisional SSI (9.1%); there were no statistically significant differences between the two groups (control group: 9.7%; experimental group: 8.6%) or between the risk factors associated with incisional SSI. Rates of overall and relevant morbidity (Clavien ≥ III) were considerable (28.1% and 9.1%, respectively), and there were no statistically significant differences between the two groups. No patients died.

Conclusion

Contralateral drainage does not significantly affect the results of primary ileostomy closure. The rate of incisional SSI was similar in the drainage and non-drainage groups, and the overall rate of 9.1% was in the low range of those reported in the literature. The absence of mortality (0%) and the non-negligible rates of overall and relevant morbidity (28.1% and 9.1%, respectively) in our series suggest that loop ileostomy is a safe procedure. However, the bowel reconstruction involves risks that must be borne in mind.

Clinical trial registration

The study was registered and approved by the clinical research ethics committee of the study center (reference number 2012076). Clinical trial was registered in ClinicalTrial.gov (identification number NCT02574702 and reference: ILEOS-ISS_2013).
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Metadata
Title
The Effectiveness of Contralateral Drainage in Reducing Superficial Incisional Surgical Site Infection in Loop Ileostomy Closure: Prospective, Randomized Controlled Trial
Authors
Anna Serracant
Xavier Serra-Aracil
Laura Mora-López
Anna Pallisera-Lloveras
Sheila Serra-Pla
Alba Zárate-Pinedo
Salvador Navarro-Soto
Publication date
01-07-2019
Publisher
Springer International Publishing
Keyword
Ileostomy
Published in
World Journal of Surgery / Issue 7/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-019-04972-6

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