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. 2017 Summer;17(2):146-149.

Use of Sodium Hyaluronate/Carboxymethylcellulose Bioresorbable Membrane in Loop Ileostomy Construction Facilitates Stoma Closure

Danielle M Bertoni  1 , Kerry L Hammond  2 , David E Beck  1   3 , Terry C Hicks  1   3 , Charles B Whitlow  1   3 , H David Vargas  1 , David A Margolin  1   3
Affiliations

Use of Sodium Hyaluronate/Carboxymethylcellulose Bioresorbable Membrane in Loop Ileostomy Construction Facilitates Stoma Closure

Danielle M Bertoni et al. Ochsner J. 2017 Summer.

Abstract

Background: Loop ileostomy is a common adjunct to surgical procedures for low rectal cancers and inflammatory bowel disease. Ileostomy closure through a limited incision can be technically challenging. We hypothesized that placing a sodium hyaluronate/carboxymethylcellulose (SH/CMC) bioresorbable membrane at loop ileostomy creation would decrease stoma closure time without increasing morbidity.

Methods: In a retrospective review at a single institution with 6 board-certified colorectal surgeons, patients with loop ileostomy creation and closure between September 1999 and December 2011 were grouped based on SH/CMC placement at ileostomy creation. Data were abstracted for age, sex, body mass index (BMI), primary diagnosis, length of surgery, staff surgeon, interval between surgeries, and postoperative morbidity. The primary endpoint was the length of the surgery for ileostomy closure. Secondary outcome measures were length of stay, wound infection rate, and other complications.

Results: A total of 293 patients were identified. Group 1 (with SH/CMC) included 146 patients, and Group 2 (without SH/CMC) included 147 patients. The groups were matched according to age, sex, BMI, interval between creation and closure, and indication for surgery. The average surgical time for closure was significantly shorter in Group 1 (46.4 minutes ± 2.7) compared to Group 2 (60 minutes ± 2.3) (P=0.0001). We found no difference between the groups in length of stay, wound infection rate, or complication rate.

Conclusion: The use of SH/CMC in loop ileostomy creation significantly decreases the operative time required for stoma closure with no increase in the complication rate.

Keywords: Ileostomy; postoperative complications; surgical stomas; tissue adhesions.

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Figures

Figure 1.
Figure 1.
A sheet of sodium hyaluronate/carboxymethylcellulose bioresorbable membrane (Seprafilm) is applied to a section of ileum selected for ileostomy creation. (To see this image in color, click to https://education.ochsner.org/publishing-services/toc/bertoni-16-0076-fig1.)
Figure 2.
Figure 2.
A sheet of sodium hyaluronate/carboxymethylcellulose bioresorbable membrane (Seprafilm) with Tevdek backing is wrapped around the piece of ileum. (To see this image in color, click to https://education.ochsner.org/publishing-services/toc/bertoni-16-0076-fig2.)
Figure 3.
Figure 3.
The ileum is wrapped in a sodium hyaluronate/carboxymethylcellulose bioresorbable membrane (Seprafilm). (To see this image in color, click to https://education.ochsner.org/publishing-services/toc/bertoni-16-0076-fig3.)
Figure 4.
Figure 4.
A loop of ileum covered with sodium hyaluronate/carboxymethylcellulose bioresorbable membrane (Seprafilm) is brought through the abdominal wall opening prior to maturation. (To see this image in color, click to https://education.ochsner.org/publishing-services/toc/bertoni-16-0076-fig4.)
See this image and copyright information in PMC

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