Archive




Volume 8, Issue 4, August 2020, Page: 132-135
A 2-year Review of Wound Outcome Following Primary Skin Closure After Laparotomy for Typhoid Ileal Perforation in Bida, Nigeria
Adekunle Adedapo Abiodun, Department of Surgery, Federal Medical Centre, Bida, Nigeria
Alexander Gomna, Department of Surgery, Federal Medical Centre, Bida, Nigeria
Emmanuel Adewale Eletta, Department of Surgery, Federal Medical Centre, Bida, Nigeria
Michael Adewale Ayeni, Department of Surgery, Federal Medical Centre, Bida, Nigeria
Adedeji Adekanye, Department of Surgery, Federal Medical Centre, Bida, Nigeria
Taofeeq Abdulrahman, Department of Surgery, Federal Medical Centre, Bida, Nigeria
Sunday Akintunde Okinbaloye, Department of Surgery, Federal Medical Centre, Bida, Nigeria
Received: Jun. 17, 2020;       Accepted: Jul. 20, 2020;       Published: Aug. 4, 2020
DOI: 10.11648/j.js.20200804.16      View  83      Downloads  29
Abstract
Introduction: Laparotomy wound for typhoid ileal perforation is a dirty wound and is usually associated with wound complications and prolonged hospital stay. Delayed primary wound closure which for long has been the most common practice after laparotomy for typhoid peritonitis is now considered to be of little significance in preventing surgical site infection (SSI). We aimed to document the incidence, severity and management of wound complications when primary closure of abdominal wounds was performed following laparotomy for typhoid ileal perforation. Patients and Methods: This was a retrospective study of all patients who had primary abdominal wound closure following laparotomy for typhoid ileal perforation in Federal Medical Centre, Bida from January 2017 to December 2018. Results: There were 71 patients with the age ranges from 2 to 41 years and their median age was 15 years who had laparotomy for typhoid ileal perforation during the study period. All 71 patients had primary closure of their abdominal wounds, however two of them died within 72 hours of operation and were excluded from the study. There were males 38 (55.1%) and females 31 (44.9%) with a male to female ratio of 1.2:1. There was primary wound healing in 23 (33.3%) patients while 44 (63.8%) of them developed incisional surgical site infections (SSI) and 2 (2.9%) developed organ space SSI. Of the 44 patients that had incisional SSI, 33 (75.0%) were superficial and 11 (25.0%) were deep. Other complications noted from the study were faecal fistulae 3 (4.3%) and incisional hernia (4.3%). Conclusion: Though a high incidence of wound morbidity is not unexpected in situation of primary closure of laparotomy wound for bacteria peritonitis, an aggressive wound management may help to reduce the incidence and severity of wound complications in such situations.
Keywords
Primary Wound Closure, Wound Complication, Ileal Perforation
To cite this article
Adekunle Adedapo Abiodun, Alexander Gomna, Emmanuel Adewale Eletta, Michael Adewale Ayeni, Adedeji Adekanye, Taofeeq Abdulrahman, Sunday Akintunde Okinbaloye, A 2-year Review of Wound Outcome Following Primary Skin Closure After Laparotomy for Typhoid Ileal Perforation in Bida, Nigeria, Journal of Surgery. Vol. 8, No. 4, 2020, pp. 132-135. doi: 10.11648/j.js.20200804.16
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Reference
[1]
Kache SA, Mshelbwala PM, Ameh EA. Outcome of primary closure of abdominal wounds following laparotomy for peritonitis in children Afr J Paediatr Surg. 2016 Oct-Dec; 13 (4): 185–188.
[2]
Cruse PJ, Foord R. The epidemiology of wound infection. A 10-year prospective study of 62,939 wounds. Surg Clin North Am. 1980; 60: 27–40.
[3]
Usang UE, Sowande OA, Ademuyiwa AO, Bakare TI, Adejuyigbe O. Outcome of primary closure of abdominal wounds following typhoid perforation in children in Ile-Ife, Nigeria. Afr J Paediatr Surg. 2009; 6: 31–4.
[4]
Ukwenya AY, Ahmed A, Garba ES Progress in management of typhoid perforation. Annals of African Medicine Vol. 10, No. 4; 2011. 259-265.
[5]
Mueller TC, Nitsche U, Victoria Kehl V, Schirren R, Schossow B, Goess R, Friess H, Reim D. Intraoperative wound irrigation to prevent surgical site infection after laparotomy (IOWISI): study protocol for a randomized controlled trial. Orphanet journal of rare disease. (2017).
[6]
Ghafouri, H. B., Zavareh, M., Jalili, F., Cheraghi, S. Is 1% povidone-iodine solution superior to normal saline for simple traumatic wound irrigation? Wound Medicine 15, 1-5, (2016).
[7]
Bigliardi PL, Alasagoff SAL, El-Kafrawi HY, Pyon JK, Wa CTC, Villa MA. Povidone iodine in wound healing: A review of current concepts and practices. International Journal of Surgery. 44, 260-268 (2017).
[8]
Norman G, Atkinson RA., Smith TA, Rowlands C, Rithalia AD, Crosbie EJ, Dumville JC. In Cochrane systematic Review (2017.).
[9]
Agrawal V, Joshi MK, Gupta AK, Jain BK. Wound Outcome Following Primary and Delayed Primary Skin Closure Techniques After Laparotomy for Non-Traumatic Ileal Perforation: a Randomized Clinical Trial Indian J Surg. 2017 Apr; 79 (2): 124–130. Published online 2016 Jan 15.
[10]
Idris OL, Idris OJ, Kolawole OA, Adejumobi MO, Adegoke AA, Oseni OG, Agbakwuru EA. Comparative Study of Wound Complications following Laparotomy for Typhoid Intestinal Perforation: Primary versus Delayed Primary Closure? A Prospective Randomized trial. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861. Volume 17, Issue 12 Ver. 4 (December. 2018), PP 49-55.
[11]
Cohn SM, Giannotti G, Ong AW, Varela JE, Shatz DV, Mckenney MG, et al. Prospective randomised trial of two wound management strategies for dirty abdominal wounds. Ann Surg 2001; 233: 409-13.
[12]
Adesunkanmi AR, Ajao OG. Typhoid ileal perforation: The value of delayed primary closure of abdominal wounds. Afr J Med Sci 1996; 25: 31-5.
[13]
Christopher OB, Primary versus Delayed – primary closure of dirty abdominal wounds in National Postgraduate Medical College of Nigeria (NPMCN) Library; Nov 1991: 84-90.
[14]
Agbakwuru EA, Adesunkanmi AR, Fadiora SO, Olayinka OS, Aderonmu AO, Ogundoyin OO. A review of typhoid perforation in a rural African hospital. West Afr J Med 2003; 22: 22-5.
[15]
Duttaroy DD, Jitendra J, Duttaroy B, Bansal U, Dhameja P, Patel G, et al. Management strategy for dirty abdominal incisions: Primary or delayed primary closure? A randomized trial. Surg Infect (Larchmt) 2009; 10: 129-36.
Browse journals by subject