Comparison of continuous single-layer and traditional interrupted suturing techniques in stoma surgery: a retrospective single-center study

Prophylactic ileostomy is frequently performed in colorectal surgery to mitigate the consequences of anastomotic leakage. The optimal fixation method, however, remains debated. We compared clinical efficiency and safety of continuous single layer versus traditional interrupted suturing for ileostomy fixation. This single-center retrospective study included consecutive patients who underwent prophylactic ileostomy fixation. Patients were grouped by fixation technique: continuous single-layer (n = 111) and traditional interruption (n = 63), as derived from the finalized case-level dataset compiled in this project. Baseline variables (age, BMI) and perioperative outcomes (stoma creation time, stoma takedown (mobilization) time, length of stay) were compared between groups. Stoma-related complications were analyzed as overall incidence. Baseline characteristics were comparable between groups (age, BMI; all p > 0.05). Compared with the interrupted method, the continuous single-layer technique was associated with a markedly shorter stoma creation time (median 17.4 vs. 28.4 min; p < 0.001) and a shorter stoma takedown (mobilization) time (median 28.0 vs. 39.5 min; p < 0.001). A small between-group difference in length of stay was observed; given potential confounding and perioperative heterogeneity, this should not be interpreted as a direct effect of the suturing technique. The overall stoma-related complication rate was similar between groups (dermatitis, prolapse, retraction, stenosis, necrosis, parastomal hernia; all p > 0.05). Using a continuous single-layer suture for ileostomy fixation shortened operative steps (creation and takedown [mobilization]) without increasing stoma-related complications compared with the traditional interrupted technique. A small reduction in hospital stay was observed but cannot be attributed solely to the suturing method. This approach is efficient and may represent an efficient alternative pending prospective validation.