Closure of abdominal incisions with subcutaneous catheters. A prospective randomized trial
M. B. Farnell, S. Worthington-Self, P. Mucha Jr, D. M. Ilstrup and D. C. McIlrath
A preliminary report from our institution suggested that closure of
abdominal incisions with subcutaneous, closed-suction catheters
intermittently irrigated with antibiotic resulted in decreased wound
infection rates. To test this hypothesis, a prospective, randomized,
controlled trial was undertaken to compare the results of primary closure,
subcutaneous catheter irrigated with saline or antibiotic, and subcutaneous
catheter alone. During the two-year trial, 3,282 incisions (type II, III,
or IV) were analyzed. Subcutaneous catheter placement alone or with
antibiotic or saline irrigation was not superior to primary closure for
type II or III incisions. A trend favoring subcutaneous catheter and
antibiotic irrigation was observed for type IV incisions. This finding
suggests that further clinical trials designed to assess the role of
subcutaneous catheter placement and antibiotic irrigation in decreasing
wound infection rates are warranted in type IV incisions.
