Wound Dehiscence and Role of Delayed Primary Closure in Gynaecological Oncology

Podder, Anirudha Rohit; Jyothi, G. S.

doi:10.1007/s40944-018-0195-8

Cited by 1 publication

(2 citation statements)

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“…Patients with comorbidities that affect wound healing such as diabetes, smoking, and long-term glucocorticoid use could benefit from the use of DPC. 55 One study published in the gynecologic oncology literature shows that patients who underwent DPC due to one or more existing comorbidities had no wound dehiscence compared with 27.3% dehiscence in the group that underwent primary closure. 55 However, it is important to note that in addition to the study’s small sample size (DPC, n=6) resulting in its exclusion from our comparative analysis, the statistical significance was not reported, further limiting its interpretation.…”

Section: Discussionmentioning

confidence: 99%

“…55 One study published in the gynecologic oncology literature shows that patients who underwent DPC due to one or more existing comorbidities had no wound dehiscence compared with 27.3% dehiscence in the group that underwent primary closure. 55 However, it is important to note that in addition to the study’s small sample size (DPC, n=6) resulting in its exclusion from our comparative analysis, the statistical significance was not reported, further limiting its interpretation. Nevertheless, it does shed some light on the possible benefits of DPC in highly comorbid patients and more importantly paves the way for future studies to better investigate this domain.…”

Section: Discussionmentioning

confidence: 99%

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Practical Review on Delayed Primary Closure: Basic Science and Clinical Applications

ElHawary,

Covone,

Abdulkarim

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Summary: Wound healing complications present a significant burden on both patients and health-care systems, and understanding wound healing principles is crucial across medical and surgical specialties to help mitigate such complications. One of these longstanding principles, specifically delayed primary closure (DPC), described as mechanically closing a wound after several days of secondary intention healing, lacks clear consensus on its definition, indications, and outcomes. This practical review examines wound healing fundamentals, focusing on DPC, its execution, indications, and comparative outcomes. A PubMed literature search was conducted to retrieve studies on DPC. Inclusion criteria included comparative studies assessing outcomes and complications between DPC and other closure techniques, as well as articles investigating DPC’s underlying physiology. Twenty-three comparative studies met inclusion criteria. DPC wounds have significantly higher partial pressure of oxygen, higher blood flow, and higher rates of collagen synthesis and remodeling activity, all of which help explain DPC wounds’ superior mechanical strength. DPC seems most beneficial in contaminated wounds, such as complicated appendectomies, postcardiac surgery wounds, and complicated abdominal wall reconstructions, where it has been associated with lower rates of surgical site infections. This practical review provides an evidence-based approach to DPC, its physiology, technique, and indications. Based on the existing literature, the authors recommend that DPC wounds should be dressed in saline/betadine soaks, changed and irrigated daily, with delayed closure lasting between 3 and 5 days or until the infection has resolved. The clearest indications for DPC are in the context of contaminated abdominal surgery and sternal wound dehiscence post cardiac surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%