{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:38:19Z","timestamp":1777934299375,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2013,11,27]],"date-time":"2013-11-27T00:00:00Z","timestamp":1385510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surgical Infections"],"published-print":{"date-parts":[[2014,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>This study was undertaken to test the veracity of the hypothesis that primary incision closure after intestinal stoma reversal in adult patients is associated with a greater risk of surgical site infection (SSI) than are open incisions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted at the Surgical Department of the Aga Khan University Hospital, Karachi, Pakistan. The study included adult patients who underwent elective loop and double-barreled intestinal stoma (ileostomy or colostomy) reversal through peristomal incisions between January 2005 and May 2011. Files were reviewed independently by two surgeons to establish main exposure (closed or open surgical sites) and outcome; i.e., SSI based on U.S. Centers for Disease Control and Prevention criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Sample size calculation prior to the study required 71 patients to be included in each exposure arm. Patients with closed surgical sites were relatively younger (mean 36\u00b115 [standard deviation] years) than those with open surgical sites (41\u00b115 years), with a male preponderance in both groups. Fifteen patients were found to have SSI: 3\/71 (4.2%) in open and 12\/71 (16.9%) in closed incisions. The risk of SSI in closed surgical sites was 5.8 times greater than in open sites (95% confidence interval for relative risk 1.5\u201322.5) after adjusting for gender, body mass index (BMI), site of stoma, malignant disease, and preoperative chemo-radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The risk of SSI in closed incisions is greater than that in open incisions. It is suggested that incisions not be closed primarily in patients undergoing stoma reversal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/sur.2012.165","type":"journal-article","created":{"date-parts":[[2013,11,27]],"date-time":"2013-11-27T17:53:24Z","timestamp":1385574804000},"page":"58-63","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Does Primary Closure Increase Surgical Site Infection after Intestinal Stoma Reversal? A Retrospective Cohort Study"],"prefix":"10.1177","volume":"15","author":[{"given":"Ghulam","family":"Murtaza","sequence":"first","affiliation":[{"name":"The Aga Khan University Hospital","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rozina","family":"Nuruddin","sequence":"additional","affiliation":[{"name":"The Aga Khan University Hospital","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayaz Ahmad","family":"Memon","sequence":"additional","affiliation":[{"name":"Dow University of Health Sciences (OJHA campus)","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tabish","family":"Chawla","sequence":"additional","affiliation":[{"name":"The Aga Khan University Hospital","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iqbal","family":"Azam","sequence":"additional","affiliation":[{"name":"The Aga Khan University Hospital","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasir","family":"Mukhtar","sequence":"additional","affiliation":[{"name":"The Aga Khan University Hospital","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,11,27]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2005.09.006"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-005-0228-z"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-010-0547-8"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-007-0457-8"},{"key":"e_1_3_3_6_2","first-page":"230","article-title":"Outcome of ileostomy closure: An audit in Surgical Ward 2, JPMC, Karachi","volume":"25","author":"Memon ZA","year":"2009","unstructured":"Memon ZA, , Qureshi S, , Murtaza M, , Maher M. Outcome of ileostomy closure: An audit in Surgical Ward 2, JPMC, Karachi. Pakistan J Surg, 2009; 25:230\u2013234.","journal-title":"Pakistan J Surg"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1445-2197.2002.02514.x"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1985.01390320077016"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7151"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2010.01.008"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-010-0753-4"},{"key":"e_1_3_3_12_2","first-page":"98","article-title":"Closure of ileostomy: A study of 74 cases","volume":"24","author":"Iqbal P","year":"2008","unstructured":"Iqbal P, , Saddique M, , Baloch TA. Closure of ileostomy: A study of 74 cases. Pakistan J Surg, 2008; 24:98\u2013101.","journal-title":"Pakistan J Surg"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e31819acc90"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0771-0"},{"key":"e_1_3_3_15_2","unstructured":"Surgical Site Infection (SSI) Event [cited March 2 2011]. Available at www.cdc.gov\/nhsn\/PDFs\/pscManual\/9pscSSIcurrent.pdf"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/9780470258019"},{"key":"e_1_3_3_17_2","first-page":"105","volume-title":"Medical Statistics at a Glance","author":"Petrie A","year":"2005","unstructured":"Petrie A, , Sabin C. Assessing agreement. In: Medical Statistics at a Glance. Second edition. Oxford, UK. Blackwell Publishing Ltd, 2005:105."},{"key":"e_1_3_3_18_2","first-page":"14414","article-title":"Stoma closure and wound infection: An evaluation of risk factors","volume":"38","author":"Hackam DJ","year":"1995","unstructured":"Hackam DJ, , Rotstein OD. Stoma closure and wound infection: An evaluation of risk factors. Can J Surg, 1995; 38:14414\u201314418.","journal-title":"Can J Surg"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1159\/000095399"},{"key":"e_1_3_3_20_2","first-page":"146","volume-title":"Modern Epidemiology","author":"Rothman KJ","year":"2008","unstructured":"Rothman KJ, , Greenland S, , Lash TL. Validity in epidemiologic studies. In: Modern Epidemiology. Third edition. Philadelphia. 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