Wound infection in patients with traumatic small intestinal injuries

Delayed closure has been the traditional management of wounds in patients with traumatic colon injury, whereas small bowel injury has generally been treated with primary wound closure. Sixty-seven patients with traumatic hollow viscus injury isolated to jejunum and ileum were reviewed to determine the incidence of septic wound complications. Fifty-eight patients underwent primary wound closure with 15 (26%) developing wound infections. Nine patients had their wounds left open because of major intraperitoneal contamination with no resulting wound infection. In patients with primary closure of their wounds, there was no difference between these developing wound infections and those without with regard to the presence of hypotension, amount of spill, type of repair, site of injury, or antibiotic given. Significant difference was present regarding time between injury and surgery (8.6 vs 17.7, P = .025). Results suggest that delayed wound closure should be performed in patients with traumatic small bowel injury.