Primary closure of ileostomy site after irrigation with betaine–polyhexanide: a case series

Surgical site infection (SSI) remains a major concern after ileostomy closure, limiting the adoption of primary closure despite the cosmetic and practical advantages of primary closure. A 0.1% betaine-0.1% polyhexanide solution, a surfactant-disinfectant solution with biofilm-disrupting properties, has been shown to significantly reduce SSI rates in various acute and chronic wounds throughout the body. This single-institution case series is the first in the literature to evaluate SSI rates with the use of betaine-polyhexanide irrigation and primary closure of ileostomy sites. All patients demonstrated well-healed incisions without SSI, wound dehiscence, or other wound-related complications at their follow-up visits 10-48 days post-operatively. Compared to the historically high SSI rates with ileostomy site primary closure, this study's findings suggest that betaine-polyhexanide irrigation may allow for safe primary closure while preserving its advantages of reduced wound care burden and improved cosmesis.