A comparative study in surgical management of ileal perforation by primary closure v/s primary closure with omental patch

Authors:SrikanthTalluri , Nischal. K
Int J Biol Med Res. 2014; 5(3): 4309-4312  |  PDF File

Abstract

Background: Ileal perforation is one of the commonest abdominal emergency.Laparotomy with primary closure is the treatment of choice depending upon the bowel condition. Fecal fistula formation is the main concern in primary closure and the incidence of this complication dramatically decreases when omentum isused as a patch over primary closure. Materials and Methods: A total of 40 patients randomized to two groups. All odd numbered patients were included in group I and underwent primary closure .All even numbered patients were included in group II and underwent primary closure with omental patch. Postoperative complications such as wound infection, intra abdominal abscess, burst abdomen, faecalfistula, septicaemia, mortality and length of hospital stay are compared. Results: Incidence of faecal fistula in primary closure group is 25%.Length of hospital stay is significantly lower in primary closure with omental patch group(p< 0.001) Conclusion: Primary closure with omental patch repair has shown betterresults compared to primary closure alone in terms of wound infection, intraabdominal abscess, burst abdomen, faecal fistula, septicaemia, mortality, length ofhospital stay irrespective of site of perforation.