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A Prospective Randomized Trial

Michael B. Farnell, MD; Susan Worthington-Self, RN; Peter Mucha, Jr, MD; Duane M. Ilstrup, MS; Donald C. McIlrath, MD

Arch Surg. 1986;121(6):641-648.

Abstract
• 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.

(Arch Surg 1986;121:641-648)

Author Affiliations
From the Departments of Surgery (Drs Farnell, Mucha, and McIlrath and Ms Worthington-Self) and Medical Statistics and Epidemiology (Mr Ilstrup), Mayo Clinic and Mayo Foundation, Rochester, Minn.

Footnotes
Accepted for publication March 4, 1986.

Read before the 93rd Annual Meeting of the Western Surgical Association, Rochester, Minn, Nov 19, 1985.

Reprint requests to Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Dr Farnell).

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