Evidence map›Paper›PMID 30809775›Full record

SynthesisTechniques in coloproctology2019

Purse-string vs. linear skin closure at loop ileostomy reversal: a systematic review and meta-analysis.

M Gachabayov, H Lee, A Chudner, A Dyatlov, N Zhang, R Bergamaschi

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Techniques in coloproctology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  17. COMPARISON BETWEEN OSTOMY CLOSURE USING PURSE-STRING VERSUS LINEAR IN CHILDREN.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

M GachabayovDivision of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA.
H LeeDivision of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA.
A ChudnerDivision of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA.
A DyatlovDivision of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA.
N ZhangDivision of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA.
R BergamaschiDivision of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Taylor Pavilion, Suite D-365, 100 Woods Road, Valhalla, NY, 10595, USA. rcmbergamaschi@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is no level 1a evidence regarding the best technique for skin closure at loop ileostomy reversal. The aim of this study was to evaluate whether purse-string skin closure (PSC) is associated with lower surgical site infection (SSI) rates as compared to linear skin closure (LC).

methodsEMBASE, MEDLINE, Pubmed, Cochrane Library, Web of Science, and CINAHL databases were systematically searched. PSC was defined as a circumferential subcuticular suture leaving a small circular skin defect allowing for free drainage, granulation, and epithelialization. In LC, the wound edges were approximated side to side with or without drainage. The primary endpoint was SSI rate. Secondary endpoints included operating time, length of hospital stay, wound healing time, and incisional hernia rates. STUDY SELECTION: Inclusion criterion was any observational or experimental study comparing PSC to LC in patients undergoing ostomy reversal.

resultsTwenty studies (6 experimental and 14 observational) totaling 1812 patients (826 PSC and 986 LC) were included. SSI rates were significantly lower statistically and clinically in patients with PSC [OR (95% CI) = 0.14 (0.09, 0.21); p < 0.0001; NNT = 6] in the meta-analysis of all studies. The subgroup analysis of randomized trials [OR (95% CI) = 0.10 (0.04, 0.21); p < 0.0001; NNT = 6] as well as the analysis of randomized trials including patients with loop ileostomy only [OR (95% CI) = 0.12 (0.05, 0.28); p < 0.0001; NNT = 5] confirmed this finding.

conclusionsThis meta-analysis found that PSC was associated with significantly decreased rates of SSI in patients undergoing loop ileostomy reversal.

Indexed as

AdultFemaleHumansIleostomyIncisional HerniaLength of StayMaleMiddle AgedOperative TimeSurgical Wound InfectionSuture TechniquesWound HealingLinear skin closureLoop ileostomy reversalPurse-string closureSurgical site infection

Identifiers

PMID30809775

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.