EARLY VS DELAYED CLOSURE IN GANGRENOUS PERFORATED APPENDICITIS: A COMPARISON OF WOUND INFECTION INCIDENCE.

Abstract

ABSTRACT
BACKGROUND: The preferred method of treatment for gangrenous or perforated
appendicitis is an open appendectomy. Perforated appendicitis is associated with a 15–20% risk
of developing post-operative wound infection, which increases the risk of morbidity by
increasing post-operative pain, longer hospital stays, suppurative wounds, patient’s
dissatisfaction and increase treatment costs. OBJECTIVE: To assess the risk of wound
infection following gangrenous/perforated appendicitis between primary and delayed primary
closure. MATERIAL & METHODS: From January to December 2020, this prospective
comparative study was carried out in the General Surgery Department of the Hayatabad
Medical Complex Peshawar. The research comprised 120 adult patients who had
appendectomy for gangrenous/perforated appendicitis. Two groups of 60 patients each were
formed. Primary wound closure was carried out in Group-A & delayed primary wound closure
in Group-B. The primary outcome measure was the rate of wound infection in the two groups.
At P0.05, statistical significance was deemed to exist. RESULTS: Total 120 Patients were
included in the study. Out of 120 patients, 75(62.5%) were males and 45(37.5%) were females.
Male patients were 41(68.3%) in Group A, and 39(65%) in Group B, whereas the female
patients were 19(31.7%) in group A and 21(35%) in group B respectively. Age ranged between
15-60 years. There were no significant differences between both groups regarding gender and
age distribution. CONCLUSION: Primary wound closure in
gangreneous/perforated appendicitis is convenient and satisfying, and it also lowers treatment
costs without increasing the risk of surgical wound infection.