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Published on: July 4, 2019

Comparison of primary wound closure versus open wound management in perforated appendicitis

Ruey-An Chiang1, Shan-Long Chen, Yao-Chung Tsai

  • 1Department of Surgery, Mackay Memorial Hospital, Taitung Branch, No. 1 Lane 303 Chang-Sha Street, Taitung 950, Taiwan. ryan@ttms.mmh.org.tw

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|September 27, 2006
PubMed

Insights

For perforated appendicitis, open wound management is preferable to primary closure in adults. This approach leads to a lower incidence of surgical wound infection (SWI) and shorter hospital stays.

Area of Science:

  • General Surgery
  • Infectious Disease

Background:

  • Open wound management is standard for perforated appendicitis.
  • Primary closure is a newer approach aiming to reduce costs and morbidity.

Purpose of the Study:

  • Compare open wound management versus primary closure for perforated appendicitis in adults.
  • Evaluate outcomes including surgical wound infection (SWI) and length of stay (LOS).

Main Methods:

  • Retrospective review of 65 adult patients with perforated appendicitis.
  • Comparison of outcomes between primary wound closure (41 patients) and open wound management (24 patients).

Main Results:

  • Primary closure resulted in a significantly higher SWI rate (43.9% vs. 4.2%, p < 0.001).
  • Patients with primary closure had a longer LOS (10 days vs. 7.9 days, p = 0.044).
  • Readmission rates were higher with primary closure but not statistically significant.

Conclusions:

  • Open wound management appears superior for perforated appendicitis in adults.
  • Lower SWI rates and shorter LOS favor open wound management.
  • Further randomized trials are necessary to confirm these findings.
Abstract

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