RANDOMIZED CONTROLLED TRIAL COMPARING THE OUTCOMES OF PLACING A SUBCUTANEOUS NEGATIVE SUCTION DRAIN DURING SKIN CLOSURE VERSUS DELAYING SKIN CLOSURE FOLLOWING A MIDLINE EMERGENCY LAPAROTOMY JHIRWALM@AIIMSJODHPUR.EDU.IN

 

RANDOMIZED CONTROLLED TRIAL COMPARING THE OUTCOMES OF PLACING A SUBCUTANEOUS NEGATIVE SUCTION DRAIN DURING SKIN CLOSURE VERSUS DELAYING SKIN CLOSURE FOLLOWING A MIDLINE EMERGENCY LAPAROTOMY

2

India

Oral or Poster

There are controversies regarding the superiority of primary closure over delayed primary closure of skin to prevent SSI following emergency laparotomies. Most of the surgeons, however, favor delaying primary closure following contaminated laparotomy. Therefore, modifications to current techniques may be necessary to reduce patient morbidity.

This study aimed to compare the patient outcome following placement of a subcutaneous negative suction drain during primary closure of skin to delayed primary skin closure in midline emergency laparotomies. A randomized controlled trial study was conducted in a tertiary care health center, between 2021 to 2022. The study included 58 patients in each group, who underwent emergency midline laparotomy for intestinal obstruction, intestinal perforation and pyo-peritoneum and compared the outcomes.

The PCS group had 26% and 19% of superficial and deep SSI rates compared to 22% and 31% in the DPC group (p= 0.67 and p=0.14). The median hospital stay was 9 and 12.5 days (p=0.29). A total of 15% and 7% of patients had mortality (p=0.15), also 60% and 52% of patients had returned to normal work in 90 days (p=0.35) in PCS and DPC groups respectively. No significant difference was found in the patient outcome of both groups (p>0.05).

Although, the overall outcomes of the patient following placement of a subcutaneous negative suction drain during primary skin closure in midline emergency laparotomy are comparable to delayed primary closure. It may, however, reduce the incidence of fascial dehiscence, improve early return to work, and shorten hospital stays.