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Evid Based Nurs 4:117 doi:10.1136/ebn.4.4.117
  • Treatment

A strategy of evaluation and delayed closure of dirty abdominal wounds reduced wound infections


 
 QUESTION: Does a strategy of evaluation and delayed primary closure (E/DPC) of dirty abdominal wounds decrease wound infection compared with primary closure (PC)?

Design

Randomised {allocation concealed}*, unblinded, controlled trial with follow up at ≥1 month.

Setting

A university hospital and a trauma centre in Miami, Florida, USA.

Patients

51 patients ≥18 years of age who were admitted to the trauma/emergency surgery or colorectal services and had dirty abdominal wounds at the time of surgery. Dirty abdominal wounds were defined as involving pre-existing clinical infection, perforated viscera, or traumatic wounds with viscus injury more than 4 hours from the time of injury with retained devitalised tissue. 96% of patients (mean age 46 y, 76% men) were included in the final analysis.

Intervention

Allocation was stratified by type of wound (appendectomy and other abdominal wounds). 26 patients were allocated to …

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