NPWT vs Primary Closure in SSI Prevention for Emergency Laparotomies for Peritonitis

definitive wound closure, not followed by secondary wound dehiscence

Time of last out-patient visit ending the process of treating surgical wound

postoperative length of hospital stay

time to full epithelialisation of the wound

Volume of wound drainage collected in a NPWT or drainage collector

Duration of NPWT therapy administered if SSI occured

occurrence of adverse events and complications following surgery measured with Clavien-Dindo scale (grade I to V; grade I represents any deviation from the normal post-operative course not requiring surgical, endoscopic or radiological intervention and grade 5 represents patient's death)

Surgical Site Infection according to Centre for Disease Control (CDC) criteria:

Infection occurring within the first 30 post-operative days with at least one of the following:

• Purulent drainage from the incision
• Organisms isolated from an aseptically obtained culture of fluid or tissue from the incision
• Incision is deliberately opened by a surgeon AND at least one of the following signs/symptoms of infection:

• Pain or tenderness
• Localized swelling
• Redness
• Heat
• Diagnosis of SSI by the surgeon or attending physician

Due to the inability to implement CDC for wounds treated with NPWT, the investigators have included additional SSI criteria: the absolute necessity to prolong NPWT after 3rd day postop, an anergic wound morphology or slough.

Pain measured with Visual Analogue Scale every 8h (subjective pain strength scale from 0 to 10; 0 represents no pain and 10 represents the worst pain)

Measured with Vancouver Scar Scale (VSS). This scale ranges from 0 (representing normal skin) to 13 (representing worst scar imaginable). VSS provides the assessment of the following wound characteristics: pigmentation (0-2), vascularity (0-3), pliability (0-5), height (0-3).

Cost of hospitalisation and outpatient visits