Primary open wound management after emergency laparotomies for conditions associated with bacterial contamination. Reappraisal of a historical tradition.

In emergency abdominal surgery associated with bacterial contamination, primary skin suture resulted in a 39 percent wound sepsis rate. After subcutaneous approximation and open skin treatment in 85 patients, healing occurred without complication. After completely open wound management in five obese patients, wound healing occurred without wound sepsis, but did result in scars necessitating correction. No difference could be found with regard to body temperature, wound healing time, and hospital stay in patients who had primary skin closure followed by primary healing and those who had open wound treatment. The patients' evaluations of the cosmetic result of open wound management using subcutaneous sutures were favorable. The study herein constitutes the rationale for our decision to institute open wound treatment routinely in pertinent cases.