A comparative study of subcutaneous negative pressure versus simple closure of skin incision following surgery for hollow viscus perforation

Background: Surgical site infection (SSI) is a significant problem associated with open abdominal surgery resulting in increased morbidity, mortality, and cost of treatment. Surgical site infection is one of the most common post-operative complications, occurring in at least 5% of all patients undergoing surgery and 30-40% of patients undergoing abdominal surgery, depending on the level of contamination. This study compares the subcutaneous single closed suction drain and simple conventional closure of skin incision in emergency laparotomy for hollow viscus perforation.Aim: The aim of the study is to determine whether the insertion of a subcutaneous closed suction drain at the incisional site reduces the incidence of post-operative surgical site infection in emergency laparotomy for hollow viscus perforation.Methodology: This is a prospective study. Fifty patients was enrolled, Patients diagnosed to have acute abdomen clinically and radiologically were planned for emergency exploratory laparotomy. They were further allocated alternately to Group I with subcutaneous closed suction drain and Group II without drain. All the patients underwent laparotomy. Postoperatively wound complications and hospital stay was recorded.Conclusion: Our study shows that subcutaneous negative pressure drainage significantly reduces the post- operative surgical site infection and duration of hospital stay following surgery for hollow viscus perforation. This helps in early recovery, better wound healing, and decreases the financial burden on patients by decreasing hospital stay and infection. As post-operative complications depend on the level of contamination, we recommend use of closed negative pressure subcutaneous drain in all patients with contaminated or dirty wounds.