Delayed primary closure of contaminated abdominal wounds: a new technique

ABSTRACT

Wound infection is a common complication after surgery for abdominal sepsis. This is more common in the patients where grossly contaminated abdominal wounds are closed primarily. OBJECTIVE: 1] To assess the efficacy of primary and delayed primary closure in prevention of postoperative wound infection of contaminated wounds. 2] To compare the morbidity with two methods of wound closure. DESIGN: Comparative study PERIOD July 1994 to June 1997. PATIENTS AND METHODS: Total 81 patients were operated having localized or generalized bacterial peritonitis during a period of 3 years at Islamia Trust Hospital Chiniot. 43 were male and 38 were female. 29[35.81%] patients had primary closure. 52 [64.119%] patients had delayed primary closure with subcutaneous proline. All patients were given appropriate peri-operative antibiotic cover. RESULTS AND COCLUSIONS 16[55.17%] patients with primary closure had wound infection and only 8 [15.38%] patients with delayed primary closure required secondary closure so; 1. There was significant reduction in wound infection after delayed primary closure of grossly contaminated wounds with subcutaneous proline stitch. 2. It is easy, economical and cosmetically superior to the primary closure and other methods of delayed closure. 3. It reduces the hospitalization and so cuts down the morbidity