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

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


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


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


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, …

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  • * Information provided by author.

  • Source of funding: no external funding.

  • For correspondence: Dr S M Cohn, Divisions of Trauma and Surgical Critical Care, Department of Surgery, University of Miami School of Medicine, Miami, FL 33136, USA. Fax +1 305 326 7065.