Open AccessEfficacy of delayed primary closure with intrawound continuous negative pressure and irrigation treatment after surgery for colorectal perforation
Author(s) -
Ogawa Katsuhiro,
Nitta Hidetoshi,
Masuda Toshiro,
Matsumoto Katsutaka,
Okino Tetsuya,
Miyamoto Yuji,
Baba Hideo,
Takamori Hiroshi
Publication year - 2021
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.633
Subject(s) - medicine , perforation , confidence interval , surgery , odds ratio , colorectal surgery , anesthesia , abdominal surgery , materials science , punching , metallurgy
Aim Surgical‐site infections (SSIs) often occur after surgery for colorectal perforation. We introduced delayed primary closure (DPC) after intrawound continuous negative pressure and irrigation treatment (IW‐CONPIT) to prevent SSIs. We aimed to evaluate the efficacy of DPC after IW‐CONPIT compared with primary closure (PC) after surgery for colorectal perforation. Methods We undertook a retrospective study including 22 patients who underwent DPC (DPC group) and 18 patients who underwent PC (PC group) at our hospital between April 2015 and January 2017. The primary outcome was the SSI rate. The secondary outcomes were other complications (<30 days), length of hospital stay, and costs. Results The SSI rate was significantly lower in the DPC group than in the PC group (40% vs. 94%, P = 0.0006). Moreover, superficial and deep incisional SSIs, infectious complications, and Clavien–Dindo classification grade ≥ 2 complications were also significantly diminished in the DPC group. Conversely, the length of hospital stay and costs were not significantly different between the two groups. Multivariate analyses revealed that the significant independent protective factor against SSI after surgery for colorectal perforation was DPC after IW‐CONPIT (odds ratio 0.04; 95% confidence interval, 0.002–0.25). Conclusion Delayed primary closure after IW‐CONPIT reduced SSIs after surgery for colorectal perforation compared with PC.