Abstract
INTRODUCTION: Majority of emergency surgeries are performed through midline laparotomy
wound; however when it comes to the closure of midline wound surgeons deploy various
options. Technique of Primary closure of the wound is simple and cost effective as no other
procedure is required. However, some surgeons favor technique of delayed primary closure
because of decreased frequency of wound infection.
OBJECTIVE: The purpose of our study was comparison of primary wound closure technique
and delayed primary wound closure techniques with respect to rate of wound infection and
other complication associated with wound infection like wound dehiscence, stitch sinuses,
incisional hernias.
PATIENT AND METHOD: This comparative study carried out among fifty patients who underwent midline exploratory laparotomy for perforated abdominal viscera in Surgical Unit I of Civil
hospital Karachi. Patients were divided into two groups. The sample size was calculated using
significance level of 0.05 and power of 80% for difference in wound infection rates in the two
groups. All patients of both genders; in each group; who underwent emergency laparotomy
having identical pathologies were taken in account. Patients with co-morbid were excluded. In
the study group (Group A), primary closure technique was used and in group B, delayed primary closure was utilized. All patients were followed for post-operative wound complications.
RESULTS: In our study male to female ratio was 2:1 and the mean age was 33±10 years. Wound
healed normally with no signs of infection in 23(46%) out of 50 patients. The overall infection
rate was considerably low in delayed closure group (40%) when compared to the primary
closure group which was 68% (p<0.05). There was significant decrease in other complication
related to wound infection like stitch abscess formation and wound dehiscence in delayed
closure group (p- < 0.05).
CONCLUSION: Our results demonstrate that the delayed primary closure technique is a better
technique with low frequency of wound infection and other related complications when compared with primary wound closure technique.
Imrana Aziz, Qamarudin Baloch, Farhan Zaheer, Muhammad Iqbal. (2015) Delayed Primary Wound Closure versus Primary Wound Closure - A Dilemma in Contaminated Abdominal Surgeries, Journal of Liaquat University of Medical and Health Sciences, Volume-14, Issue-3.
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