Low Rate of Surgical Site Infection After Primary Wound Closure in Emergency Abdominal Surgery

PURPOSE: Surgical site infection is common after emergency abdominal surgery. In this study, we aimed to determine the surgical site infection rate in emergency abdominal surgery with primary wound closure and ordinary wound dressings in an advanced bundle care setting. Secondly, we aimed to identify risk factors for surgical site infection.

METHOD: A retrospective analysis of patients undergoing emergency abdominal surgery for visceral perforation, ischemia, hemorrhage, bowel obstruction, or other urgent pathology with primary wound closure and use of standard surgical dressings was conducted in Copenhagen University Hospital North-Zealand, Denmark.

RESULTS: 772 patients were analyzed. The overall surgical site infection rate was 12.6%. Patients undergoing an emergency laparoscopy had significantly less surgical site infection compared to open surgery (3.0% vs. 15.9%, p < 0.001). We identified body mass index ≥ 30 (OR: 2.2; 95% CI: 1.3-3.7 [p = 0.004]), peritonitis (OR: 1.9; 95% CI: 1.2-3.2 [p = 0.011]), stoma formation (OR: 1.9; 95% CI: 1.1-3.4 [p = 0.023]), and laparotomy (OR: 5.8; 95% CI: 2.4-14.5 [p < 0.001]) to be significant risk factors for the development of surgical site infection.

CONCLUSION: We conclude that primary wound closure and ordinary dressings after emergency abdominal surgery in an advanced bundle care setting showed low rates of surgical site infection.