Primary Skin Closure after Repair of Hollow Viscus Injuries

Area of Science:

• Trauma Surgery
• Surgical Site Infections
• Abdominal Trauma

Background:

• Decisions on skin closure for hollow viscus injuries (HVIs) in trauma patients often rely on surgeon judgment and perceived surgical site infection (SSI) risk.
• Optimizing wound management in HVIs is crucial for patient outcomes.

Purpose of the Study:

• To investigate whether leaving the skin open after operative repair of HVIs reduces wound complications, specifically superficial or deep SSIs.
• To identify factors associated with SSI development in patients with HVIs.

Main Methods:

• Retrospective analysis of adult patients undergoing operative repair of HVIs.
• Data collected included patient demographics, injury details, and wound complication rates.
• Superficial or deep surgical site infections (SSIs) were the primary outcome measure.

Main Results:

• Of 141 patients, 38 (27%) had HVIs, and 26 (18.4%) developed SSIs.
• 13 (50%) of the SSIs were superficial or deep.
• Adjusted analysis revealed female gender (P=0.03) and higher base deficit (P=0.001) as significant predictors of wound infections.
• Open wound management was not associated with a decreased incidence of SSIs (P=0.19).

Conclusions:

• Open wound management strategies did not demonstrate a reduced incidence of SSIs in patients with HVIs.
• Female gender and base deficit are significant factors associated with wound infections in this patient population.
• Further research is needed to establish optimal strategies for minimizing wound complications in patients with HVIs.