Comparing Delayed vs Primary Wound Closure After Emergency Laparotomy: Impact on Infection, Healing, and Hospital Stay

NCT ID: NCT07142395

Last Updated: 2025-09-05

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 82 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-05-16
• Study Completion Date: 2025-08-15

Brief Summary

The purpose of this study is to find out which type of wound closure after emergency abdominal surgery leads to fewer wound infections and better recovery: closing the wound immediately after surgery (called primary closure) or waiting a few days before closing the skin (called delayed primary closure).

Wound infection is a common problem after emergency abdominal surgery (also called laparotomy). Some surgeons close the skin right away, while others wait a few days to reduce the risk of infection.

This study will help find out which method is better.

The main questions the study aims to answer are:

1. . Does delayed primary closure lower the rate of wound infection compared to primary closure?

2. . Does the wound open up (wound dehiscence) less often with delayed closure?

3. . Does delayed closure affect the length of hospital stay?

In this clinical trial:

• Adult patients needing emergency abdominal surgery will be included.
• Half the patients will have their wounds closed immediately (primary closure), and half will have delayed closure after 3-5 days of daily dressing.
• All surgeries will be done by experienced surgeons using the same technique.
• Patients will be followed for 4 weeks after surgery to monitor wound infection, wound opening, and length of hospital stay.

The results will help doctors choose the safest and most effective way to close surgical wounds after emergency abdominal surgery.

Conditions

Laparotomy Closure After Abdominal Surgery

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Primary Closure

Skin closed immediately after laparotomy

Group Type: ACTIVE_COMPARATOR

Immediate skin closure

Intervention Type: PROCEDURE

After laparotomy wounds will be closed primarily using no. 1 vicryl suture

Delayed Primary Closure

Skin closed 3 - 5 days after laparotomy

Group Type: EXPERIMENTAL

Delayed primary closure

Intervention Type: PROCEDURE

Deeper layers of wound will be closed after surgery and loose mattress sutures will be applied to skin with prolene. After three to five days of daily dressing with bactericidal solution, the skin will be closed

Interventions

Immediate skin closure

After laparotomy wounds will be closed primarily using no. 1 vicryl suture

Intervention Type: PROCEDURE

Delayed primary closure

Deeper layers of wound will be closed after surgery and loose mattress sutures will be applied to skin with prolene. After three to five days of daily dressing with bactericidal solution, the skin will be closed

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Patients 18 - 60 years of age
• Either male or female gender and
• Planned to undergo emergency laparotomy

Exclusion Criteria

• Patients undergoing second laparotomy
• Re- laparotomy
• On steroid therapy and
• Patients who die within 28-days of surgery

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Bkahtawar Amin Medical and Dental College Multan

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Amjad A Professor, FRCS

Role: STUDY_CHAIR

Bakhtawar Amin Medical and Dental College

Locations

Bakhtawar Amin Medical and Dental College

Multan, Punjab Province, Pakistan

Countries

Pakistan

Other Identifiers

U1111-1326-2839

Identifier Type: -

Identifier Source: org_study_id