Loose knots and surgical site infections in abdominal surgeries (clean-contaminated and contaminated wounds)

Background: Surgical site infections (SSIs) are associated with high healthcare costs and worsen the post-operative course of a considerable proportion of general abdominal surgical patients. SSIs raise the risk of post-operative morbidity and mortality, necessitating hospitalization, intravenous antibiotics, and potentially surgical reintervention. The aim of the study was to compare the outcome of intermittent loose knots and the conventional vertical mattress suturing in patients undergoing abdominal surgeries.Methods: This prospective comparative study was done in patients undergoing emergency abdominal surgeries for any cause. Patients were divided into 2 groups- (a) group 1 (45 patients): intermittent loose knots between conventional vertical mattress sutures; (b) group 2 (45 patients): conventional vertical mattress suturing.Results: In this study, 31% of patients were in the 41-50 years age group, 53.3% of patients were male. Among various abdominal surgery opted, laparotomy was the most commonly performed procedure (47%). In this study, group 1 patients shown a decrease in wound gap, secondary wound closure and delayed wound approximation than group 2 patients.Conclusions: Loose knots in between conventional vertical mattress sutures are better than conventional vertical mattress suturing in terms of wound gap, secondary wound closure and delayed wound approximation.

Platelet-Rich Fibrin in Combination with Local Antibiotics Optimizes Wound Healing After Deep Sternal Wound Problems and Prevents Reinfection

Objective: Disturbed wound healing is a significant problem in patients after cardiac surgery. Problems with deep sternal wound healing are rare, but can be quite difficult to treat. Furthermore, the therapy is highly expensive and consumes many of the patient’s personal resources. Another major obstacle in this patient group is reinfection after secondary wound closure. We examined how to prevent early reinfection through the use of growth factors in combination with local antibiotics. Methods: Our study included 232 patients with a deep sternal wound healing problem. After initial vacuum therapy, we planned secondary wound closure. During wound closure, we used only platelet-rich fibrin in a PRF group (109 patients). In another group (123 patients), we covered the wounds intraoperatively with a combination of PRF and local antibiotics (PRF CoDelivery). All patients were observed for 30 days for signs of early surgical site infection. Results: After 30 days, 22 patients (20.2%) in the PRF group showed a persistent problem with wound healing with or without reinfection. In contrast, only 12 patients (9.8%) in the PRF CoDelivery group had this problem (p=0.023 PRF vs. PRF CoDelivery). Conclusion: The combination of growth factors and antibiotics was associated with a significantly reduced incidence of early reinfection and thus can be expected to have a positive impact on wound healing in complicated scenarios. Furthermore, the combination of PRF and local antibiotics was easy to use. Further studies are needed to verify these initial findings.