Role of Delayed Primary Closure in Reducing Superficial Surgical Site Infection in Contaminated Abdominal Wounds
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Delayed primary closure is an effective technique for reducing SSSI in contaminated laparotomy woundsAbstract
Introduction: Surgical site infection (SSI) is a major postoperative complication, especially in contaminated abdominal wounds. While primary closure (PC) is common practice, delayed primary closure (DPC) is hypothesized to reduce superficial surgical site infection (SSSI) rates. To evaluate the role of DPC in reducing superficial surgical site infection (SSSI) in contaminated abdominal wounds.
Methods: A prospective observational study of 100 patients undergoing laparotomy with contaminated wounds was conducted at Sher-E-Bangla Medical College Hospital. Following fascial closure, the skin was left open and packed with saline-soaked gauze. Delayed skin closure was performed when healthy granulation tissue appeared, typically after the fifth postoperative day (POD).
Results: Only 12% of patients developed SSSI after DPC. The average length of hospital stay was 10.8 ± 2.5 days. SSSI rates varied by diagnosis: 25% for ileal perforation and 12.5% for perforated appendicitis.
Conclusion: Delayed primary closure is an effective technique for reducing SSSI in contaminated laparotomy wounds.
Journal of Surgical Sciences 2025;29(1): 37-41
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