Delayed primary closure versus subcutaneous suction drain with primary closure following contaminated laparotomy...

Surgical site infections (SSIs) remain a major cause of morbidity and prolonged hospitalization following emergency contaminated laparotomies and the optimal method of skin closure in such wounds is still debated. Therefore, it is of interest to evaluate delayed primary closure (DPC) versus primary closure with subcutaneous suction drain (PC-D) in 120 adults undergoing emergency contaminated laparotomies at a tertiary care centre between January 2023 and June 2025. SSIs occurred in 13.3% of patients in the DPC group and 23.3% in the PC-D group, a difference that did not reach statistical significance, while hospital stay was significantly longer in the DPC group. Readmission rates and early SSI rates were comparable between groups and diabetes, obesity and hypoalbuminemia were identified as independent predictors of SSI. Although DPC showed a trend toward lower SSI rates, it was associated with longer hospitalization, suggesting that wound closure strategies in contaminated laparotomies should be individualized, particularly in high-risk patients. In high-risk patients (e.g., diabetics), DPC may be superior. Thus, we recommend for tailored approaches in contaminated wounds, with larger trials needed for definitive guidelines.