No abstract

A controlled, randomized study of the efficacy of a plastic wound ring drape (Opdrape, Triplus) to prevent contamination and infection in elective colorectal operations is reported. Seventy patients were operated upon with the wound ring drape and 70 patients without. All patients received preoperative systemic antibiotic prophylaxis. Abdominal wound infection was observed in seven of 70 (10 per cent) patients with the wound ring drape and six of 70 (9 per cent) without (N.S.). An operative swab for bacteriologic evaluation was obtained from 85 per cent of the wounds. There was no evidence that the drape protected the wound from contamination with intestinal bacterial flora. It was concluded that the wound ring drape prevents neither contamination nor infection.

No abstract

From 1973 to 1981, a total of 30 patients undergoing reoperative surgery for serious septic complications were treated without closure of the abdominal cavity. The open wound was covered with gauze soaked in saline. Intraabdominal abscesses could then be evacuated directly, if necessary, under slight general anesthesia in the patient's own bed. Reperitonealization and excess growth of granulation tissue was seen within 2 weeks. Sixteen patients survived. In 10 of these, the wound healed secondarily without any other treatment. In the remaining 6, split‐skin grafts or a pedicled flap was necessary. In 4 patients the abdominal wall almost reestablished itself. The remaining 12 patients showed larger or smaller defects with negligible problems. Patients with severe abdominal sepsis, associated with necrotic wound edges, multiple laparotomies, and multiple organ failures should have the abdominal cavity left completely open.