Primary closure—CLOSED allocation (Control arm)
SITE INFECTION
This strategy consists of primary closure of the fascia using any technique or suture material as chosen by the attending surgical team. Closure of the skin and the method for preventing surgical site infections is left to the discretion of the attending surgeon. There is no expectation for relaparotomy. Postoperative diagnostic imaging and all other aspects of postoperative care including any decision to perform a relaparotomy shall be at the discretion of the treating critical care/surgical teams. A decision to perform a relaparotomy will constitute a study outcome. If at any subsequent laparotomy the attending and responsible surgeon selects an open abdominal strategy (crossover to the intervention arm), the outcomes will be analyzed based on the intention-to-treat allocation at the time of original enrollment. Any application of any wound suction or negative pressure device to the soft tissue above a closed fascia is permitted within the control arm (closed abdomen).