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Impact of relationship between the stoma site and the primary incision on occurrence of laparotomy wound infection in contaminated or dirty wound operations in neonates

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Abstract

Background

In neonatal surgical patients requiring an enterostomy, there is no definitive recommendation regarding the ideal enterostomy location: at the edge of the primary incision or at a different incision.

Methods

We retrospectively reviewed 2005–2017 administration data in our institution. All neonatal patients who underwent contaminated or dirty wound laparotomy and enterostomy construction were evaluated regarding the enterostomy location, occurrence of postoperative incisional surgical-site infection (SSI) at the primary incision, and stoma-related complications.

Results

Patients were divided into two groups based on stoma location: at the primary incision (the same incision group: SI group, n = 16) or at another incision (different incision group: DI group, n = 23). We performed 2 jejunostomies, 13 ileostomies, and 1 colostomy in the SI group, and 4 jejunostomies, 18 ileostomies, and 1 colostomy in the DI group. One of 16 patients (6.3%) in the SI group and 2/23 patients (8.7%) in the DI group experienced superficial incisional SSI, with comparable SSI incidence between groups (p = 0.78). Every SSI did not result in stoma-related complications.

Conclusions

Although the enterostomy location did not influence the incidence of laparotomy wound infection in this study, prospective studies are mandatory to fully assess the safety of enterostomy construction at the edge of the primary incision.

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Acknowledgements

We thank Jane Charbonneau, DVM, and Angela Morben, DVM, from Edanz Group (http://www.edanzediting.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Mikihiro Inoue, Keiichi Uchida, Yuka Nagano, Kohei Matsushita, Yuhki Koike, Yoshiki Okita, Yuji Toiyama, Toshimitsu Araki & Masato Kusunoki

  2. Department of Surgery, Mie Prefectural General Medical Center, 5450-132 Hinaga, Yokkaichi, Mie, 510-8561, Japan

    Kohei Otake

Authors
  1. Mikihiro Inoue
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  2. Keiichi Uchida
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  3. Yuka Nagano
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  4. Kohei Matsushita
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  5. Yuhki Koike
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  6. Kohei Otake
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  7. Yoshiki Okita
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  8. Yuji Toiyama
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  9. Toshimitsu Araki
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  10. Masato Kusunoki
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Corresponding author

Correspondence to Mikihiro Inoue.

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The authors have no conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

Written informed consent was obtained from all of patients or guardians enrolled in this study.

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Inoue, M., Uchida, K., Nagano, Y. et al. Impact of relationship between the stoma site and the primary incision on occurrence of laparotomy wound infection in contaminated or dirty wound operations in neonates. Pediatr Surg Int 34, 957–960 (2018). https://doi.org/10.1007/s00383-018-4310-9

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  • DOI: https://doi.org/10.1007/s00383-018-4310-9

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