A Study to Compare the Outcome of Primary versus Delayed Primary Closure of Skin in Contaminated and Dirty Laparotomy Wound
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 3
Abstract
Abstract: Surgical site infections are common following the abdominal surgeries. Centre for disease control has found 45% SSI incidence in abdominal surgeries with contaminated wounds. This is still a matter of debate whether delayed primary closure of skin in contaminated and dirty abdominal laparotomy wound is superior to primary closure to reduce morbidity of surgical site infection or not. This study is done to compare Primary closure and Delayed primary closure of skin in contaminated and dirty abdominal wound to find whether delayed primary closure reduces the rate of morbidity and hospital stay as compare to primary closure or not. This study was a prospective randomized controlled trial, which was conducted in Surgical Unit 6, the Upgraded Department of General Surgery, SMS Medical College & attached hospitals during the period of May 2016 to April 2017. Sample size was calculated to be 30 subjects for each of two groups. Patients were undergo laparotomy procedure for acute Peritonitis were included in this study. During surgery peritoneal lavage was performed For primary closure, wound’s skin was closed with monofilament interrupted suture. For delayed primary closure, skin and subcutaneous tissue were left open and packed with 10 % povidone iodine (betadine) soaked gauge, which were changed daily to prevent excessive collection of exudates. First dressing was changed after 48 hours and incision site was closely examined. There was a significant association between wound infection and type of skin closure (delayed primary closure 13.33% vs primary closure 53.33% (p<0.003). The mean post-operative stay, 7.1 days were seen in delay primary closure group and 8.93 days were in primary group. Delayed primary skin closure may represent a simple, reliable, and potentially cost-effective way of reducing SSI following abdominal surgery with contaminated or dirty wounds. Keywords: PC- Primary closure, SSI- surgical site infection, DPC- delayed primary closure.
Authors and Affiliations
Hemant Jain, Richa Jain, Jagram Meena, Shubhanshu Gaurav, B. R. Barala
Keywords
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