Surgical Site Infection in Primary versus Delayed Primary Closure in Complicated Appendicitis

Abstract

Objective: The objective of the study was to compare the frequency of SSI of primary versus delayed primary closure among the patients with complicated appendicitis. Materials & Methods: A randomized controlled trial having110 patients with the diagnosis of complicated appendicitis was conducted at the General Surgery Department, District Headquarters Hospital Rawalpindi, from February 28, 2021 to August 27, 2021. The wound of the patients included in group A was washed using normal saline (NS), and rectus muscle and skin were closed with prolene 1 and silk 2-0 vertical mattress sutures in primary closure (PC), respectively. On the other hand, the wound of the patients included in group B was washed with NS and rectus muscles were closed with prolene 1-0 while sutures were not applied to skin and a saline-soaked gauze dressings was placed for delayed primary closure (DPC) on the 5th postoperative day. The presence or absence of SSI was assessed for 7 days post-operatively. Results: The patients in group A and group B had mean age of 37.05 ± 5.99 and 38.67 ± 6.99 years, respectively. Most of the patients (54.55%) fell within the age range of 15 to 40 years. Of 110 patients, 68.18% and 31.82% were males and females, respectively. The SSI was reported in 9.09% and 25.24% patients with primary closure and delayed primary closure, respectively (p = 0.023). Conclusion: The frequency of SSI is less in patients with primary closure in complicated appendicitis as compared to delayed primary closure.

Keywords: Complicated appendicitis, Surgical site infections, Primary Closure, Delayed primary closure