Role of Delayed Primary Skin Closure in Preventing Superficial Abdominal Wound Infections in Peritonitis Patients

Abstract

Background: The commonest complication encountered postoperatively is wound infection despite the use of
prophylactic antibiotics and following meticulous surgical techniques. The rate of surgical site infection is higher in case
of contaminated surgeries as compared to elective surgeries.
Objectives: To determine whether delayed primary skin closure of contaminated and dirty abdominal incisions reduces
the rate of surgical site infections (SSI)(superficial abdominal) compared with primary skin closure.
Methods: 50 patients who were above 18 years of age, admitted to our hospital through the emergency department and
underwent exploratory laparotomy for perforated viscera, and the intraabdominal collection was included in this study.
Results: The cause of perforation was, 8(32%) cases of perforated appendicitis, traumatic perforation(8), ileal perforation(5)
and duodenal perforation(4). In group A 17(68%) patients had wound infection and 10 (40%) had wound infection in
group B. The distribution of wound infection in each respective subgroup with p-value. There was significant difference
in stitch abscess formation and wound discharge between two groups (p-value< 0.05) i.e., 7(28%) patients of group A,
developed stitch abscess while 6 patients developed wound discharge. However, no patient in group B developed stitch
abscess and wound discharge. 1(4%) patient developed erythema in group A, while it was none in any patients of group B.
Conclusion: Delayed primary closure is better than primary closure in minimizing wound infection. But all patients who
were grouped in delayed primary closure who underwent secondary closure had to stay more in hospital which is not
cost-effective