Background: Surgical site infections (SSI) are the most common complication after stoma closure. Circular skin closure (CSC) has been proposed to reduce SSI with comparable or even better outcomes than conventional primary sutures (PS). The aim of this meta-analysis is to compare circular with primary skin closure in stoma closure.

Method: A systematic review of the literature was performed for articles published between January 2010 and June 2023, including all randomized control trials (RCT) on wound infection of adult patients following stoma reversal. The primary outcome was 30-day SSI; secondary outcomes were operative time, length of stay, and incisional hernia.

Results: Eight RCTs were identified that included a total of 606 patients undergoing stoma closure surgery. Four percent of patients in the CSC group developed SSI, compared to 27% of patients undergoing PS. The 30-day SSI rate was lower after the circular skin closure (OR 0.11, 95% CI 0.06-0.21; p < 0.00001, I² = 0%). There was no difference in the operative time (99.2 vs 103.5 min; MD - 0.17, 95% CI - 0.37, 0.03; p = 0.10), length of stay (7.1 vs 7.7 days; MD - 0.34, 95% CI - 0.55, - 0.12; p = 0.002), and incisional hernia rate (2% vs 4%; OR 0.61, 95% CI 0.23, 1.60; p = 0.31).

Conclusion: CSC is associated with lower SSI rate and should be preferred to linear skin closure technique after stoma closure surgery.

Keywords: Ostomy closure; Postoperative complications; Skin closure; Surgical wound infection.

© 2025. The Author(s).

背景: 手术部位感染（SSI）是造口还纳术后最常见的并发症。环形皮肤闭合（CSC）已被提出可减少 SSI，并且与传统的原发缝合（PS）相比，其效果相当甚至更好。本 meta 分析的目的是比较环形和原发性皮肤闭合法在造口还纳术中的应用。

方法: 系统回顾了 2010 年 1 月至 2023 年 6 月期间发表的相关文献，包括所有涉及成人患者术后伤口感染的随机对照试验（RCT）。主要结局指标是 30 天内的 SSI；次要结局指标为手术时间、住院时间和切口疝的发生率。

结果: 共确定了 8 篇 RCT 文章，涉及 606 名接受造口还纳术的患者。CSC 组中有 4% 的患者发生 SSI，而 PS 组中这一比例为 27%。环形皮肤闭合后的 30 天内 SSI 发生率较低（OR=0.11, 95% CI 0.06-0.21；p

结论: 环形皮肤闭合与较低的 SSI 发生率相关，且在造口还纳术后应优先采用线性皮肤闭合法。

关键词: 造口关闭；术后并发症；皮肤闭合；手术伤口感染。