Agrawal Vivek, Joshi Mohit Kumar, Gupta Ashish Kumar, Jain Bhupendra Kumar
Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India 110029.
Indian J Surg. 2017 Apr;79(2):124-130. doi: 10.1007/s12262-015-1438-x. Epub 2016 Jan 15.
To study the effect of primary and delayed primary closure of skin incision on wound outcome in patients with non-traumatic ileal perforation, 68 patients of ileal perforation were studied in a prospective randomized clinical trial. Patients fulfilling inclusion criteria were divided into ileostomy and non-ileostomy groups, both of which were then randomized into two subgroups each depending on whether skin was closed primarily or in a delayed primary manner. Wound infection and dehiscence were the main outcome parameters studied. The data collected was analyzed using appropriate statistical tools taking significant value at 5 %. Most patients were 21-30 years of age. Male:female ratio was 3.2:1. The overall incidence of wound infection was 63 %. Wound infection was strongly associated with the incidence of superficial wound dehiscence and total wound dehiscence that were 11.76 and 47 %, respectively. Mortality was 10.3 %. Methodology of wound closure has no significant impact on incidence of wound infection, wound dehiscence, and mortality, although the onset of wound complications is significantly delayed with delayed primary closure of the skin.
为研究一期缝合与延迟一期缝合皮肤切口对非创伤性回肠穿孔患者伤口结局的影响,在一项前瞻性随机临床试验中对68例回肠穿孔患者进行了研究。符合纳入标准的患者被分为造口组和非造口组,然后根据皮肤是一期缝合还是延迟一期缝合,将每组再随机分为两个亚组。伤口感染和裂开是主要研究的结局参数。收集的数据使用适当的统计工具进行分析,显著性水平设定为5%。大多数患者年龄在21至30岁之间。男女比例为3.2:1。伤口感染的总体发生率为63%。伤口感染与浅表伤口裂开和全层伤口裂开的发生率密切相关,分别为11.76%和47%。死亡率为10.3%。伤口缝合方法对伤口感染、伤口裂开和死亡率的发生率没有显著影响,尽管皮肤延迟一期缝合会显著延迟伤口并发症的发生。