Risk factors and incidence of surgical wound infection after stoma reversal: A systematic review and meta-analysis

Abstract

To determine the incidence and risk factors of incisional infection following stoma reversal surgery. As of July 30, 2024, an extensive literature search was conducted on databases including PubMed, Web of Science, Cochrane, Embase, and OpenGrey. The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Data analysis was performed using Stata 14.0.20 articles were included, with a total sample size of 8542, including 723 patients with incision infection. The incidence of incision infection was 12%(95%CI:0.094–0.145). The results identified 5 patient-related risk factors of incisional infection, including stoma type (OR: 3.06, P = 0.015), inflammatory bowel disease (OR: 1.91, P = 0.012), Body Mass Index (BMI; OR: 1.12, P < 0.01), period from stoma creation (OR: 0.18, P = 0.012), and surgical site infection (SSI) after primary surgery (OR: 3.57, P < 0.01), and 3 surgery-related risk factors, including subcutaneous drainage (OR: 0.26, P = 0.019), suture method (OR: 4.83, P < 0.01), operation time > 60 min (OR: 4.33, P < 0.01), operation time (continuous variable, OR: 1.004, P < 0.01). Clinical staff can refer to the influential factors in this study to reduce the incidence of incision infection.