68-6

40/104

604may be a more significant difference in the RR and scarring period.In our study, some NPWT-related problems were observed. NPWT was unable to be performed completely due to pain (4 patients), bleeding (3 patients) or SSI (1 patient) (Figure 3). The V.A.C® system was used for 5 of 8 patients with these NPWT-related problems. As the V.A.C® system has stronger suction pressure than the PICO® system, complications, such as pain and bleeding, may have been due to the suction pressure of NPWT. There are few reports on the safety of NPWT for PSC; therefore, further studies are required.There are several limitations to this study. First, it was a single-institutional superior trial. As the number of patients was insufficient to examine superiority, multi-institutional clinical trials are expected in the future. Second, both the V.A.C® system and PICO® system were used as NPWT in this study. In general, the suction pressure of V.A.C® is 120 mmHg and that of PICO® is 80 mmHg, thus the suction pressure of V.A.C® is stronger. This inconsistency may have affected the outcome. Third, we may have incorrectly assessed the scarring period. As the schedule of outpatient visits after discharge was not set in advance, there may have been a difference in scarring period depending on the day of outpatient visit. Fourth, this study did not evaluate the cost effectiveness of prophylactic NPWT or patient satisfaction (cosmetic outcome and difficulty of wound care). These factors should be assessed in future studies. We are awaiting the results of the SR-PICO study11).ConclusionIn this study, PSC+NPWT was suggested to might be effective for early wound healing of stoma closure. NPWT-related complications are infre-quent, but care for pain and bleeding is needed when using NPWT.AcknowledgmentsWe would like to thank the Medical English Service for checking the grammar and spelling of this manuscript.The authors received no financial support for the research. 1) Fujii S, Yamamoto S, Ito M, et al: Short-term outcomes of laparoscopic intersphincteric resection from a phase II trial to evaluate laparoscopic surgery for stage 0/I rectal cancer: Japan Society of Laparoscopic Colorectal Surgery Lap RC. Surg Endosc, 2012; 26: 3067-3076. 2) Munakata S, Ito S, Sugimoto K, et al: Defunctioning loop ileostomy with restorative proctocolectomy for rectal cancer: Friend or foe? J Anus, Rectum Colon, 2018; 1: 136-140. 3) Garnjobst W, Leaverton GH, Sullivan ES: Safety of colostomy closure. Am J Surg, 1978; 136: 85-89. 4) Todd GJ, Kutcher LM, Markowitz AM: Factors influ-encing the complications of colostomy closure. Am J Surg, 1979; 137: 749-751. 5) Demetriades D, Pezikis A, Mellssas J, et al: Factors influencing the morbidity of colostomy closure. Am J Surg, 1988; 155: 594-596. 6) Banerjee A: Pursestring skin closure after stoma reversal. Dis Colon Rectum, 1997; 40: 993-994. 7) Sutton CD, Williams N, Marshall LJ, Lloyd G, Thomas WM: A technique for wound closure that minimizes sepsis after stoma closure. ANZ J Surg, 2002; 72: 766-767. 8) Cantero R, Rubio-Perez I, Leon M, et al: Negative-Pres-sure Therapy to Reduce the Risk of Wound Infection Following Diverting Loop Ileostomy Reversal: An Initial Study. Adv Skin Wound Care, 2016; 29: 114-118. 9) Poehnert D, Hadeler N, Schrem H, Kaltenborn A, Klempnauer J, Winny M: Decreased superficial surgical site infections, shortened hospital stay, and improved quality of life due to incisional negative pressure wound therapy after reversal of double loop ileostomy. Wound Repair Regen, 2017; 25: 994-1001.10) Uchino M, Hirose K, Bando T, Chohno T, Takesue Y, Ikeuchi H: Randomized Controlled Trial of Prophy-lactic Negative-Pressure Wound Therapy at Ostomy Closure for the Prevention of Delayed Wound Healing and Surgical Site Infection in Patients with Ulcerative Colitis. Dig Surg, 2016; 33: 449-454.11) Kim S, Kang SI: The effectiveness of negative-pres-sure wound therapy for wound healing after stoma reversal: a randomised control study (SR-PICO study). Trials, 2020; 21: 24.12) Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG: CDC definitions of nosocomial surgical site infec-YK, KT, KA, YT, KH, RT, MK, KS and MT made substantial contributions to conception and design, acquisition of data. SN analysis and interpretation of data and statistical analysis. KS made contribu-tions to drafting the article; and final approval of the version to be published. All authors read and approved the final manuscript.The Authors declare that there are no conflicts of interest.FundingAuthor contributionsConflicts of interest statementReferences