An Experience with Primary versus Delayed Primary Wound Closure in Dirty Abdominal Surgery

Abstract

Objectives:  To evaluate as primary closure versus delayed primary closure in dirty abdominal surgeons.

Study Design: Observational / descriptive study.

Place and Duration of Study: This study was conducted at two units surgery at tertiary care academic hospitals of Liaquat University of Medical and Health Science (LUMHS) Jamshoro and Peoples University if Medical and Health Science (PUMHS) Nawabshah from March 2014 to May 2016

Materials and Methods: 100 patients of both genders from 18 - 62 years in age. Who underwent in exploratory laparotomy for gut perforation or intra-abdominal abscess by two units were involved in this prospective interventional randomized control (RCT). Study population was divided into A and B Groups, based on having primary closure and delayed primary closure respectively. The randomization of patients samples was simple by alternating technique. While samples were of equal size 70 in each group to maintain balance. Study population was divided into A and B Groups, based on having primary closure and delayed primary closure respectively. The randomization of patients samples was simple by alternating technique. Primary and secondary outcomes were SSI and length of history and incisional hernia respectively.

Results: All patients in both groups (28(30%) operated for either penetrating or blunt abdominal trauma were in between (21-32 years). In this plot of 94 patients, 25 (26.5%) from both groups developed wound infection. While in group A, the incidence of SSI was 36% versus 17% of Group B. The total length of hospital stay was bit greater in group B versus A. while rate of post-operative complications and re-admission was higher in group A versus group B. Cause of death was not wound infection in both groups.

Conclusion: Delayed primary closure is safe and effective with reduce rates of SSI as in our part of the world, where infectious disease are on the top and hospital resources are limited.