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 …
