A Comparative Study between Traditional Wound Closure and Subcutaneous Negative Pressure Drain Closure for Midline Incision in Emergency Laparotomy to Prevent Surgical Site Infection

Abstract

Background: Surgical site infection is the most common postoperative complication after emergency laparotomy which associated with prolonged hospital stay, increased cost of treatment etc. Even after sensitivity based antibiotic use and judicious irrigation of wound with saline, it remains a major concern. Materials and Methods: This Quasi Experimental study was conducted among 104 patients from January 2022 to June 2023. The patients were divided equally into two groups: Group-I (closure over subcutaneous negative pressure drain) and Group-II (traditional wound closure). Finally, wound complications and hospital stay were recorded. The test statistics to be used are descriptive statistics, Chi-square (2) and student’s t-Test. P-value 0.05 considered as a statistically significant. Results: The demographics parameters indicated no significant differences in age and gender distribution. Surgical site Infection showed significant reduction in Group-I than Group-II (9.6% vs 32.7%, p=0.004). Similarly, the incidence of wound dehiscence was also lower in Group-I than Group-II (1.9% vs 11.5%, p=0.050) which was statistically significant. Burst abdomen and seroma also lower in Group-I (p=0.153). Furthermore, duration of hospital stays and readmission for SSI was significantly shorter in Group-I compared to Group-II (5.44±1.88 days vs 7.62 ± 3.95 days, p=0.001 and 1.9% vs 13.5%, p=0.027). Conclusion: The utilization of subcutaneous negative pressure drain closure showed   statistically significant advantages over traditional wound closure in terms of preventing surgical site infection, wound dehiscence, length of hospital stays and readmission rate for surgical site related complications. The incidence of burst abdomen was also fewer among negative pressure drain group but not statistically significant Therefore, subcutaneous negative pressure drain closure had potential benefit in reducing surgical site related complications following emergency laparotomy with peritonitis.