Comparison of surgical incision complete closure versus leaving skin open in wound class IV in emergent colon surgery.

INTRODUCTION: Our aim was to compare the effect of techniques of wound closure in the emergent colon surgery with wound class IV.

METHODS: Using 2014 the colectomy targeted ACS-NSQIP dataset; we identified patients undergoing emergent colectomy with wound class IV. Comparison of surgical incision complete closure versus leaving the skin open and multivariate logistic regression analyses was performed.

RESULTS: Of 1792 patients undergoing emergent colectomy with wound class IV, the complete closure cohort had 1376 patients and the incision skin open cohort had 416 patients. The incidence of deep SSI was 2.3% in the complete closure cohort vs. 1.2% in the incision skin open, p = 0.15, and intra-abdominal abscess rate was 11.8% in the complete closure cohort vs. 12.3% in the incision skin open, p = 0.78. The dehiscence rate, readmission rate, and reoperation rates were not statistically significant between two cohorts. A multivariate model for dehiscence did not yield significant association between the complete closure cohort and incision skin open cohort.

CONCLUSIONS: Surgical incision complete wound closure in the emergent colon surgery with wound class III/IV is safe and effective.