Primary Skin Closure after Repair of Hollow Viscus Injuries

Author:

Holloway Janell12,Lett Elle34,Marcia Lobsang12,Putnam Brant5,Neville Angela5,Patel Neil5,Chong Vincent5,Kim Dennis Y.5

Affiliation:

1. David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California;

2. Charles R. Drew University of Medicine and Science College of Medicine, Los Angeles, California

3. Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania;

4. Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania; and

5. Department of Surgery, Harbor-UCLA Medical Center, Torrance, California

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.

Publisher

SAGE Publications

Subject

General Medicine

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