Comparative study of wound healing in primary versus delayed primary closure in contaminated abdominal surgery
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Hellenic Journal of Surgery (2016) 88:5, 314-320
Comparative Study of Wound Healing in Primary Versus Delayed Primary Closure in Contaminated Abdominal Surgery Prashant Kumar Singh, Neeraj Saxena, Devadatta Poddar, Rohit Kumar Gohil, Gaurav Patel
Abstract Aim: To determine optimal wound closure strategy in contaminated abdominal surgery. Background Data: Wound Infection in contaminated abdominal surgery is very common and affects morbidity
and mortality of patients. There is inconclusive evidence regarding superiority of two wound closure strategy i.e., primary closure (PC) and Delayed Primary Closure (DPC) in terms of wound infection. Methods: A total of 80 patients with contaminated abdominal wounds related to hollow viscus perforation were enrolled. They were prospectively randomised to have their surgical wound managed by either primary closure or delayed primary closure on fifth post op day or later if wounds were not pristine. SSI was considered if there was pus discharge from the incision site. The primary outcome measure was the incidence of wound infection and length of hospital stay. Results: The overall infection rate for a total 0f 80 cases was 30%. The pc group had a higher incidence of wound infection (42.5%) vs 17.5% (p- 0.027) and longer length of stay (LOS) (20.7 days vs 18.1 days. (p- 0.039) Conclusion: Delayed primary closure is better strategy for management of contaminated abdominal wound.it reduces
the wound infection rate and length of hospital stay. Key words: Delayed primary closure; contaminated abdominal surgery; primary closure; surgical site infection
Introduction Infection has always been a feature of human life and sepsis in modern surgery continues to be a significant problem for health care practitioner across the globe. Surgical site infection (SSI) is one of the most common hospital acquired types of infection [1,2], which is caused by contamination, especially from the enteric endogenous viscus bacteria. Surgical site infection contributes greatly to the morbidity and mortality associated with surgery [3,4], along with sequel of wound infection, like wound dehiscence and incisional hernia, can result in long term problems [5,6,7]. Post op wound infection has a significant impact on health resources and cost [8,9].
Prashant Kumar Singh, Neeraj Saxena, Devadatta Poddar, Rohit Kumar Gohil, Gaurav PatelSurgeon Surgeon Department of General & Minimally Invasive Surgery, PGIMER & Dr RML Hospital, New Delhi, India Corresponding author: Dr Prashant Kumar Singh Senior Resident, Department of Surgery, Room No-100, First Floor, OPD Building, PGIMER & Dr RML Hospital, New Delhi -110001 e-mail: [email protected] Received 14 July 2016; Accepted 10 August 2016 Hellenic Journal of Surgery 88
Out of many risk factors influencing post-operative wound infection, the method of skin closure has been implicated as an important factor. Delayed primary closure (DPC) and Primary closure (PC) are two commonly used methods but there is no consensus as to the optimum method. Delayed primary clos
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