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

## TL;DR

This study shows that using a betaine–polyhexanide solution during ileostomy closure may reduce surgical site infections and allow for safe primary closure.

## Contribution

First case series evaluating betaine–polyhexanide irrigation for ileostomy site primary closure and its impact on surgical site infections.

## Key findings

- All patients had well-healed incisions without surgical site infections or wound complications.
- Betaine–polyhexanide irrigation may enable safe primary closure of ileostomy sites.
- The solution could reduce wound care burden and improve cosmetic outcomes.

## Abstract

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.