Effect of delayed primary closure on the healing of ischemic wounds.

ABSTRACT

OBJECTIVE: To study the influence of delayed primary closure on the healing of ischemic wounds in rats. METHODS: Wounds sutured after a delay of 3 days were compared with primary closed wounds by biomechanical testing. RESULTS: The delayed wounds were as strong as primary closed wounds when tested 10 days after wounding. Thirteen days after wounding (10 days after closure), nearly all the biomechanical parameters of the delayed wounds were increased, compared with those of primary closed wounds that had healed for 10 days. The wounds closed after a delay were weaker, however, when tested 20 days after wounding. CONCLUSION: An ischemic wound can safely be left open for 3 days before suturing, i.e., for prevention of infection in contaminated wounds, without affecting the biomechanical properties at the time of removing the sutures, which is often performed clinically 10 to 12 days after the operation.