Primary Skin Closure after Repair of Hollow Viscus Injuries

Am Surg. 2019 Oct 1;85(10):1139-1141.

Abstract

Decisions regarding whether to close the skin in trauma patients with hollow viscus injuries (HVIs) are based on surgeon discretion and the perceived risk for an SSI. We hypothesized that leaving the skin open would result in fewer wound complications in patients with HVIs. We performed a retrospective analysis of all adult patients who underwent operative repair of an HVI. The main outcome measure was superficial or deep SSIs. Of 141 patients, 38 (27%) had HVIs. Twenty-six patients developed SSIs, of which 13 (50%) were superficial or deep SSIs. On adjusted analysis, only female gender (P = 0.03) and base deficit were associated (P = 0.001) with wound infections Open wound management was not associated with a decreased incidence of SSIs (P = 0.19) in patients with HVIs. Further research is required to determine optimal strategies for reducing wound complications in patients sustaining HVIs.

MeSH terms

  • Abdominal Injuries / surgery*
  • Abdominal Wound Closure Techniques / adverse effects*
  • Abdominal Wound Closure Techniques / statistics & numerical data
  • Adult
  • Antibiotic Prophylaxis / statistics & numerical data
  • Dermatologic Surgical Procedures / adverse effects*
  • Dermatologic Surgical Procedures / methods
  • Duodenum / injuries
  • Female
  • Humans
  • Intestine, Small / injuries
  • Jejunum / injuries
  • Male
  • Retrospective Studies
  • Skin
  • Statistics, Nonparametric
  • Stomach / injuries
  • Surgical Wound / surgery*
  • Surgical Wound Infection / classification
  • Surgical Wound Infection / epidemiology*
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control