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Masaya KAWAI1), Kiichi SUGIMOTO1), Makoto TAKAHASHI1), Kazuhiro SAKAMOTO1)3)Department of Surgery, Institute for Juntendo University Urayasu Hospital, Chiba, Japan1)Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan2)Medical Technology Innovation Center Clinical Research and Trial Center Juntendo University, Tokyo, JapanKota AMEMIYA1), Yuki TSUCHIYA1), Kumpei HONJO1), Rina TAKAHASHI1), Corresponding author: Yu OkazawaDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, JapanTEL: +81-3-3813-3111　FAX: +81-3-3813-0731　E-mail: yokazawa@juntendo.ac.jp〔Received　Aug. 7, 2022〕〔Accepted　Sep. 29, 2022〕J-STAGE Advance published date: Dec. 1, 2022Copyright © 2022 The Juntendo Medical Society. This is an open access article distributed under the terms of Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original source is properly credited. doi: 10.14789/jmj.JMJ22-0015-OABackground: Although purse-string skin closure (PSC) is an effective method for stoma closure considering wound infection, the period for scarring will be prolonged. The aim of this study was to assess whether negative-pressure wound therapy (NPWT) can reduce the wound-scarring period for PSC after stoma closure.Methods: Patients who underwent stoma closure between January 2015 and August 2020 at our department were retrospectively assessed. Patients in the control group received only PSC, and patients in the NPWT group received both PSC and NPWT using the VAC® or PICO®. The primary endpoint of this study was the short-term reduction ratio (RR). The RR is calculated by the length, width, and depth of the wound of the stoma closure site. The secondary endpoints were scarring period and wound-related complications such as surgical site infection, dermatitis, bleeding, enterocutaneous fistula, and ventral hernia.Results: Of the 53 patients included in this study, 21 had their stoma closed by PSC and 32 had their stoma closed by PSC plus NPWT. No significant differences were observed in patient characteristics or peri-operative states. The RR in the NPWT group was significantly smaller than that in the PSC group at 7 postoperative days (p=0.04). There was no difference in scarring period between the two groups (p=0.11). The rates of postoperative wound-related complications were similar in the two groups (control group: 4 (19%), NPWT group: 7 (21.9%), p=1.0).Conclusions: Our study suggests that PSC plus NPWT might be more effective for wound healing after stoma closure than only PSC.Key words: stoma closure, purse-string skin closure, negative-pressure wound therapyJuntendo Medical Journal2022. 68(6), 599-605Original ArticlesStudy of Purse-string Skin Closure Plus Negative-pressure Wound Therapy for Stoma ClosureIntroductionRecently, surgical techniques for lower rectal cancer have advanced and opportunities to select sphincter-preserving surgeries, such as super low anterior resection and intersphincteric resection, have increased1), thus the frequency of diverting stoma construction has also increased2).Stoma closure is a relatively less-invasive surgery, but surgical site infection (SSI) is regarded as a problematic postoperative complication. SSI was reported in 10 to 45% as a complication after stoma closure3-5). When SSI occurs, the patient’s satisfac-tion with treatment decreases due to extension of the hospitalization period and increase in medical expenses.As a method for preventing wound infection, purse-string skin closure (PSC) is available. In 599Yu OKAZAWA1), Yutaka KOJIMA1), Kazuhiro TAKEHARA1, 3), Shouko NOJIRI2),