关键词: 肠造口, 造口还纳, 十字缝合技术, 切口感染, 愈合时间

Abstract: Objective To summarize the experience of gunsight closure technique in loop stoma reversal.Methods This retrospective trial enrolled 22 patients who underwent gunsight stoma closure.The main techniques were as followings：The skin was sewn continuously 0.2cm away from the edge of the stoma to close the stoma.After intestinal anastomosis，the intestine was incorporated into the abdominal cavity and the fascial closure was achieved en masse continuously with PDS II.The subcutaneous adipose tissue was sutured by circular absorbable suture and leaving a residual hole of 1cm in the center.Grasped the skin and pulled it toward the center of the wound to mark four points and triangles of 0，3，6，and 9 o’clock.Resected the four triangles and placed a circumferential absorbable subcuticular suture in the wound edge，leaving a small residual hole of 0.5cm in the center of the wound，leaving a drainage strip in the hole.Interrupted sutured the wound.Results The median blood loss was 20ml（10～40ml），median operative time was 70min（60～90min），median postoperative hospital stay was 6.5 days（5～8 days）.There was only one patient（4.5%）with surgical site infection on the second day postoperatively.The median healing time was 17 days（14～22 days）.The median cosmetic score according to the visual analog scale（0 being the lowest and 10 the highest grade in cosmetic scar perception of the patient）was 9（6～10）with a median followup of 14 months（10～21 months）.Conclusion Gunsight closure might be a relatively safe and feasible technique for stoma reversal，and might lower the wound tension，shorter wound healing time and postoperative hospital stay with satisfied cosmetic results，without prolonged operative time and increased postoperative pain.

Key words: stoma, stoma reversal, gunsight closure, surgical site infection, wound healing time