Laparotomy Closure After Abdominal Surgery
Conditions
Keywords
wound infection, primary wound closure, delayed wound closure, Wound dehiscence
Brief summary
The purpose of this study is to find out which type of wound closure after emergency abdominal surgery leads to fewer wound infections and better recovery: closing the wound immediately after surgery (called primary closure) or waiting a few days before closing the skin (called delayed primary closure). Wound infection is a common problem after emergency abdominal surgery (also called laparotomy). Some surgeons close the skin right away, while others wait a few days to reduce the risk of infection. This study will help find out which method is better. The main questions the study aims to answer are: 1. . Does delayed primary closure lower the rate of wound infection compared to primary closure? 2. . Does the wound open up (wound dehiscence) less often with delayed closure? 3. . Does delayed closure affect the length of hospital stay? In this clinical trial: * Adult patients needing emergency abdominal surgery will be included. * Half the patients will have their wounds closed immediately (primary closure), and half will have delayed closure after 3-5 days of daily dressing. * All surgeries will be done by experienced surgeons using the same technique. * Patients will be followed for 4 weeks after surgery to monitor wound infection, wound opening, and length of hospital stay. The results will help doctors choose the safest and most effective way to close surgical wounds after emergency abdominal surgery.
Interventions
PROCEDUREImmediate skin closure
After laparotomy wounds will be closed primarily using no. 1 vicryl suture
PROCEDUREDelayed primary closure
Deeper layers of wound will be closed after surgery and loose mattress sutures will be applied to skin with prolene. After three to five days of daily dressing with bactericidal solution, the skin will be closed
Sponsors
Bkahtawar Amin Medical and Dental College Multan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Patients 18 - 60 years of age * Either male or female gender and * Planned to undergo emergency laparotomy
Exclusion criteria
* Patients undergoing second laparotomy * Re- laparotomy * On steroid therapy and * Patients who die within 28-days of surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Wound Infection | From date of surgery to Four weeks postoperatively | Surgical Site infection - Presence any features of erythema, pain, pus discharge on examination of surgical wound and new onset fever (\> 98.6 F) |
Other
| Measure | Time frame | Description |
|---|---|---|
| Hospital Stay | From date of surgery until date of hospital discharge, up to 28 days | Duration of stay (days) in hospital after laparotomy |
| Wound dehiscence | From date of laparotomy to Four weeks post-operatively | A partial or total separation of previously approximated wound edges |
Countries
Pakistan
Outcome results
None listed