The Value of Delayed Primary Wound Closure in Perforated Appendicitis

Abstract

Background: the wound infection is the most common complication following operation for perforated appendix. Drainage and systemic antibiotic agents have not altered the incidence of wound sepsis in cases of perforated appendicitis with primary wound closure.Aims of study: to study the delayed primary wound closure in preventing wound infection in cases of perforated appendicitis.Patients and methods: This is a prospective study conducted on 216 patients with appendicitis who underwent operation at surgical wards of Al – Yarmouk Teaching Hospital, from January 2005- august 2008. The range of age from 11-56year, mean age was 33.5 years. For comparison purposes, the patients were divided into three groups:Group I:- uncomplicated (non perforated) appendicitis.Group II:- perforated appendicitis were treated with appendicectomy and primary wound closure. Group III: perforated appendicitis who were treated with appendicectomy and delayed primary wound closure. All the three groups patients were treated in the following manner:-Grid-iron incision done. Aspiration or swabs of peritoneal fluid or pus and appendix stump and wound edges were taken &send to the laboratory &cultured for aerobic and anaerobic bacteria, appendicectomy done after ligation of the mesoappendix and tube drains used.Results: There were no deaths encountered in the series of 216 patients. Wound infection was defined as any purulent discharge from the wound requiring drainage or repeated dressing, or any collection of purulent exudates in the wound requiring repeated dressing or drainage.Group I:-wound infection occurred in5.26%.Group II:- wound infection was noted in29.03%. Group III. wound infection occurred in 3.03%.