Effects of Delayed Skin Closure of Midline Laparotomy Incisions for Peritonitis
DOI:
https://doi.org/10.51985/JBUMDC2025807Keywords:
Delayed Primary Closure, Laparotomy, Peritonitis, Wound Dehiscence, Wound InfectionAbstract
Objective: To compare outcomes of delayed versus early primary closure of midline laparotomy wounds in peritonitis.
Study Design and Setting: A randomized controlled trial was carried out during the period from 26th February, 2025 to
30th August, 2025 using consecutive sampling at the Department of Surgery, GMMMC Hospital, Sukkur.
Methodology: After getting ethical approval and consent, eighty patients aged 20-70 years (ASA I-III) were enrolled in
this study, undergoing upper midline laparotomy closure for peritonitis. They were randomly placed in Group A (delayed
primary closure) and Group B (early primary closure). All were taken up under one team of general anesthesia in the
operating theatre. A 15-day follow-up was done for infection and dehiscence of the wound.
Results: Out of 80 patients, the overall wound infection rate was 33.8 %, which was significantly higher in Group B (45
%) compared with Group A (22.5 %); p = 0.033. The incidence of wound dehiscence was higher in Group B as compared
to Group A (p = 0.019). Anemia was associated with increased complications, especially early closure. The time taken for
surgery was same but blood loss was more with delayed closure (354.10 ± 42.36 ml vs. 305.25 ± 35.46 ml; p < 0.001).
Conclusion: Delayed primary closure of the wound can reduce the incidence of infection and dehiscence in case of
peritonitis, although there is a slight increase in blood loss observed.
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Copyright (c) 2026 Liaqat Ali , Imamuddin Baloch, Javeria Memon, Ahsan Ali, Muhammad Sheeraz, Altaf Hussain (Author)
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