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Original Article

J Liaquat Uni Med Health Sci. 2015; 14(3): 110-114


Delayed Primary Wound Closure versus Primary Wound Closure - A Dilemma in Contaminated Abdominal Surgeries

Imrana Aziz, Qamarudin Baloch, Farhan Zaheer, Muhammad Iqbal.

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 3310 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

Key words: Contaminated abdominal surgery, wound closure, wound complications, wound infection.






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