Early reclosure versus conventional secondary suture of severe wound abscesses following laparotomy.

The study comprised 81 consecutive cases of severe incisional abscesses following laparotomy during a 28-month period. Severe incisional abscess was defined as wound infection necessitating opening of the entire wound down to the fascia. During the first 12 months of the study period, 30 patients had conventional secondary suture with a median time of 12 days from drainage of wound abscesses until closure of clean and granulating wounds. During the last 16 months, 51 patients had early closure of contaminated wounds 4 days after drainage under systemic antibiotic cover with clindamycin. The surgical technique used in early closure allowed complete occlusion of the wound cavity without sutures in the wound itself. Recurrent incisional infection occurred in 3 of 30 patients having secondary suture and in 1 of 51 having early reclosure. It is concluded that early reclosure under systemic antibiotic cover is a safe procedure, which reduces hospitalization and convalescence.