Comparison of Surgical Site Infections, Operative Outcomes and Scar Assessment in Gunsight Closure Technique versus Linear Closure for Stoma Reversal- A Randomized Clinical Trial

Abstract Purpose Stoma closure is associated with an increased risk of surgical site infection (SSI) and poor cosmetic scar. The incidence of SSI depends on the skin closure technique, the ideal stoma-site skin closure technique is still debated. The aim of this study was to compare the rate of SSI and scar assessment following the gunsight closure technique (GCT) and the linear closure technique (LC). Methods In this randomized clinical trial, 75 patients were enrolled who underwent stoma closure between November 2021 and April 2023. Patients were divided into two groups according to the skin closure technique, GCT (n = 41) and LC (n = 34). The incidence of SSI, readmission rates, length of hospital stays, and patients' scar satisfaction scores were compared. Results The two groups were similar in baseline and intra-operative characteristics, six (14.6%) patients in GCT group and 10 (29.4%) in the LC group developed SSI, and the difference was not significant. The length of hospital stay was significantly shorter in the GCT group (6.29 ± 2.43). Four patients were readmitted for SSI in LC group and none in the GCT group (p = 0.038). Patients in the GCT group were more satisfied with the scar at one month intervals based on the patient and observer scar assessment scale (POSAS). Conclusion GCT was associated with a lower incidence of SSI, a significant decrease in length of hospital stay, and a lower 90 days readmission rate for SSI as compared to LC. The cosmetic outcome was significantly more acceptable after GCT.