Outcome of primary closure of abdominal wounds following laparotomy for peritonitis in children
Background: Primary wound closure following laparotomy for peritonitis is generally believed to be associated with wound complications and long hospital stay. Open wound management has long been the most common practice after laparotomy for peritonitis. Primary closure (PC), however, has recently be...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2016-01-01
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| Series: | African Journal of Paediatric Surgery |
| Subjects: | |
| Online Access: | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2016;volume=13;issue=4;spage=185;epage=188;aulast=Kache |
| _version_ | 1819297106595151872 |
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| author | Stephen Akau Kache Philip M Mshelbwala Emmanuel A Ameh |
| author_facet | Stephen Akau Kache Philip M Mshelbwala Emmanuel A Ameh |
| author_sort | Stephen Akau Kache |
| collection | DOAJ |
| description | Background: Primary wound closure following laparotomy for peritonitis is generally believed to be associated with wound complications and long hospital stay. Open wound management has long been the most common practice after laparotomy for peritonitis. Primary closure (PC), however, has recently been advocated to reduce cost and morbidity. This study determined the incidence and severity of wound complications and their impact on hospital stay and overall outcome when PC of abdominal wounds is done following laparotomy for peritonitis. Patients and Methods: A prospective review of patients who had PC of abdominal wounds following laparotomy for peritonitis over a 6-year period. Results: Fifty-six children were analysed (35 boys and 21 girls), aged 11 months to 13 years (median: 8 years). The indication for laparotomy was typhoid intestinal perforation 47 (83.9%), perforated appendicitis 4 (7.1%), complicated cholecystitis 3 (5.3%) and penetrating abdominal injury with bowel perforation and intestinal obstruction with bowel perforation, 1 (1.8%) each, respectively. Postoperatively, 34 patients had wound complications. Nine patients (16.1%) had superficial wound infection alone, 12 (21.4%) had superficial wound infection with partial wound dehiscence, 6 (10.7%) had deep wound infection, 7 (12.5%) had deep wound infection with complete wound dehiscence, whereas 22 (39.3%) had no wound complication. Overall, wound complications in 13 (23.2%) patients were considered to be severe, but none resulted in mortality. Hospital stay in patients who developed wound complications was 8–37 days (median: 25 days) and 6–22 days (median: 10 days) in patients who had no wound complications (P = 0.02). Conclusion: The rate of wound complications following PC of dirty abdominal wounds remain but PC is safe and gives good healing outcomes. |
| first_indexed | 2024-12-24T05:08:44Z |
| format | Article |
| id | doaj.art-90fcf25cb8024f56bf991720dd034197 |
| institution | Directory Open Access Journal |
| issn | 0189-6725 |
| language | English |
| last_indexed | 2024-12-24T05:08:44Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | African Journal of Paediatric Surgery |
| spelling | doaj.art-90fcf25cb8024f56bf991720dd0341972022-12-21T17:13:45ZengWolters Kluwer Medknow PublicationsAfrican Journal of Paediatric Surgery0189-67252016-01-0113418518810.4103/0189-6725.194669Outcome of primary closure of abdominal wounds following laparotomy for peritonitis in childrenStephen Akau KachePhilip M MshelbwalaEmmanuel A AmehBackground: Primary wound closure following laparotomy for peritonitis is generally believed to be associated with wound complications and long hospital stay. Open wound management has long been the most common practice after laparotomy for peritonitis. Primary closure (PC), however, has recently been advocated to reduce cost and morbidity. This study determined the incidence and severity of wound complications and their impact on hospital stay and overall outcome when PC of abdominal wounds is done following laparotomy for peritonitis. Patients and Methods: A prospective review of patients who had PC of abdominal wounds following laparotomy for peritonitis over a 6-year period. Results: Fifty-six children were analysed (35 boys and 21 girls), aged 11 months to 13 years (median: 8 years). The indication for laparotomy was typhoid intestinal perforation 47 (83.9%), perforated appendicitis 4 (7.1%), complicated cholecystitis 3 (5.3%) and penetrating abdominal injury with bowel perforation and intestinal obstruction with bowel perforation, 1 (1.8%) each, respectively. Postoperatively, 34 patients had wound complications. Nine patients (16.1%) had superficial wound infection alone, 12 (21.4%) had superficial wound infection with partial wound dehiscence, 6 (10.7%) had deep wound infection, 7 (12.5%) had deep wound infection with complete wound dehiscence, whereas 22 (39.3%) had no wound complication. Overall, wound complications in 13 (23.2%) patients were considered to be severe, but none resulted in mortality. Hospital stay in patients who developed wound complications was 8–37 days (median: 25 days) and 6–22 days (median: 10 days) in patients who had no wound complications (P = 0.02). Conclusion: The rate of wound complications following PC of dirty abdominal wounds remain but PC is safe and gives good healing outcomes.http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2016;volume=13;issue=4;spage=185;epage=188;aulast=KacheAbdominalperitonitispost-operative complicationsurgical site infection |
| spellingShingle | Stephen Akau Kache Philip M Mshelbwala Emmanuel A Ameh Outcome of primary closure of abdominal wounds following laparotomy for peritonitis in children African Journal of Paediatric Surgery Abdominal peritonitis post-operative complication surgical site infection |
| title | Outcome of primary closure of abdominal wounds following laparotomy for peritonitis in children |
| title_full | Outcome of primary closure of abdominal wounds following laparotomy for peritonitis in children |
| title_fullStr | Outcome of primary closure of abdominal wounds following laparotomy for peritonitis in children |
| title_full_unstemmed | Outcome of primary closure of abdominal wounds following laparotomy for peritonitis in children |
| title_short | Outcome of primary closure of abdominal wounds following laparotomy for peritonitis in children |
| title_sort | outcome of primary closure of abdominal wounds following laparotomy for peritonitis in children |
| topic | Abdominal peritonitis post-operative complication surgical site infection |
| url | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2016;volume=13;issue=4;spage=185;epage=188;aulast=Kache |
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