Conventional wound management versus a closed suction irrigation method for infected laparotomy wound--a comparative study

Abstract

Objective: The aim of this study was to evaluate the efficacy of a closed suction irrigation method for the management of infected laparotomy wounds.

Methods: This is a retrospective study on consecutive patients with infected laparotomy wounds managed in a single tertiary referral hospital from January 2004 to March 2009. The wounds were laid open, debrided and cleansed with hydrogen peroxide, povidone iodine and normal saline. The wounds were either conventionally treated with normal saline dressings followed by secondary suturing when healthy granulation tissues were formed (the Control group) or by the closed suction irrigation method after suturing the wound (the Study Group).

Results: There were 70 patients in the Study Group and 60 patients in the Control Group. The hospital stay (mean ± SD, 9.2 ± 0.1 vs. 20.5 ± 0.6 days, P < 0.001) and time to wound healing (mean ± SD, 8.1 ± 0.1 vs. 18.5 ± 0.6 days, P < 0.001) were significantly better in the Study Group than in the Control Group. The re-infection rate was also significantly lower in the Study Group (7.1% vs. 21.7%, P < 0.05).

Conclusions: Encouraging results were obtained with the use of the closed suction irrigation method for infected laparotomy wounds. The closed suction irrigation method decreased hospital stay and allowed early rehabilitation. The findings of our study need to be substantiated in large-scale randomized controlled trials.