COMPARISON BETWEEN DELAYED PRIMARY CLOSURE AND IMMEDIATE PRIMARY CLOSURE OF ABDOMINAL INCISIONS IN PATIENTS WITH SEPTIC PERITONITIS.

Background: It is still a point of controversy if performing delayed primary closure (DPC) of abdominal incisions in cases of abdominal septic operations could be able to reduce incidence of surgical-site infection and its bad long term sequels in comparison with immediate primary closure (PC). The Aim: To compare between delayed primary closure and immediate primary closure of abdominal incisions, in patients with peritonitis that results from septic operations regarding superficial surgical site infection. Patients & Methods: we have carried out such study on 60 patients with septic peritonitis that were collected and operated surgically during 2 years in in Department of General Surgery, Zagazig University Hospital. We have divided our cases into 2 groups; Group (1): cases that are managed by immediate PC of the skin and subcutaneous tissue using polypropylene sutures and insertion of subcutaneous drain. Group (2): included cases that are managed by DPC of the skin and subcutaneous tissue, using polypropylene sutures and without insertion of drain. We have followed all patients for 2 weeks for; infection or dehiscence of the wound and for occurrence of burst abdomen, seroma or sub cutaneous collection. Results: we have detected that DPC is better than immediate PC as regard decreasing incidence of wound infection & dehiscence (p=0,009), less liability for occurrence of burst abdomen (p=0.042), sub cutaneous collection (p=0.003) and seroma (p<0.001). Conclusion: performing DPC will be better than immediate PC in management of patients with septic peritonitis.