Damage Control Laparotomy Wound Incisions Can Be Closed With Low Rates of Superficial Surgical Site Infections

Abstract

Due to high rates of surgical site infections (SSIs) in damage control laparotomies (DCLs), many surgeons leave wounds to heal by secondary intention. We hypothesize that patients after DCL can have their wounds primarily closed with wicks/Penrose drains with low rates of superficial surgical site infections. A retrospective review of a prospectively maintained DCL database was performed for all patients who underwent DCL from January 2016 to June 2018. From January 2016 to June 2018, a total of 171 patients underwent DCL. After exclusions, 107 patients were reviewed to assess for SSI. 57 patients were closed with wicks/Penrose drains, 3 were closed with delayed primary closure, and 47 patients were closed completely at time of fascial closure. There were 4 (3.7%) superficial SSIs, 13 (12.1%) organ space infections, and 14 surgical site occurrences (3 of which required opening the skin). Primary closure of incisions after DCL has low superficial SSI rates.

Keywords

damage control laparotomy surgical infection wicks primary closure superficial surgical site infections

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References

Wei

Green

Kao

, et al. Accurate risk stratification for development of organ/space surgical site infections after emergent trauma laparotomy. J Trauma Acute Care Surg. 2019;86(2):226-231. doi:10.1097/TA.0000000000002143

Pommerening

Kao

Sowards

Wade

Holcomb

Cotton

. Primary skin closure after damage control laparotomy. Br J Surg. 2015;102(1):67-75. doi:10.1002/bjs.9685

Norman

Atkinson

Smith

, et al. Intracavity lavage and wound irrigation for prevention of surgical site infection. Cochrane Database Syst Rev. 2017;10(10):CD012234. doi:10.1002/14651858.CD012234.pub2

AMERICAN COLLEGE OF SURGEONS DIVISION OF EDUCATION Blended Surgical Education and Training for Life . Wound Home Skills Kit Surgical Wounds [Pamphlet]. Chicago, IL: American College of Surgeons; 2018. https://www.facs.org/-/media/files/education/patient-ed/wound_surgical.ashx.