# A case series of delayed primary closure of abdominal laparotomy incisions after perforated diverticulitis

## TL;DR

This paper presents three cases where delayed closure of abdominal incisions after surgery for a gut infection reduced the need for outpatient wound care and prevented infections.

## Contribution

The study introduces evidence that delayed primary closure reduces outpatient wound care needs after contaminated abdominal surgeries.

## Key findings

- Three patients who had delayed primary closure did not require additional wound care after discharge.
- None of the patients developed surgical site infections postoperatively.
- Delayed closure with negative pressure wound therapy minimized outpatient care and costs.

## Abstract

The management of contaminated abdominal incisions after surgery for perforated hollow viscus organs remains controversial. Limited studies have shown some benefits to delayed primary closure over primary closure, specifically related to a decrease in surgical site infections (SSI) and decreased length of stay; however, there is little research looking at its effect on decreasing outpatient wound care needs. The three patients successfully underwent delayed primary closure of their midline incisions after exploratory laparotomy for perforated diverticulitis. None required additional wound care in the form of home health, wound care clinic visits, or nursing facility placement after discharge. All three patients did not develop any SSIs postoperatively. This case series demonstrated that delayed primary closure with the aid of negative pressure wound therapy is an effective way to minimize outpatient wound care needs and costs and is effective at managing contaminated abdominal incisions.