The impact of wound management on postoperative wound infection in perforated appendicitis

Abstract

Purpose: Appendectomy is still most commonly performed emergency surgical procedure. Infection of the operative incision is the most common cause of morbidity after appendectomy for complicated acute appendicitis.

Background: Open wound management after complicated (gangrenous or perforated) acute appendicitis was common practice but, recently, primary closure has been advocated to reduce costs and morbidity. Medical records of 445 patients with a median age of 32 years (range 11-85) who had complicated appendicitis between 1997-2003 were evaluated retrospectively. The patients were subgrouped according to type of wound management. Patients in pimary closure and delayed closure subgroups were compared for age, gender, white blood cell count (WBC) on admission, American Society of Anesthesiologist class, APACHE II score, duration of operation, pathological diagnosis, length of hospital stay, the rate of wound infection and mortality.

Results: Overall 64.9 % of the surgical wounds was closed primarily and 35.1 % was left open at the end of operation. There was no difference in terms of WBC count, duration of operation, length of hospital, and rate of wound infection between the groups.

Conclusion: Based on the study results, we think that primary wound closure in perforated appendicitis is a safe and favourable wound management method.