EFFICACY OF PRIMARY WOUND CLOSURE IN PATIENTS WITH PERFORATED APPENDICITIS IN TERMS OF POSTOPERATIVE SURGICAL SITE INFECTION

Perforated Appendicitis

Abstract

Objective: The objective of this study was to find out the efficacy of primary wound closure with a subcutaneous
drain versus delayed primary closure in prevention of postoperative surgical site infection in patients with
perforated appendix.
Study Design: Randomized control trial.
Place and Duration of Study: Surgical department PNS Shifa Karachi, from May 2015 to Nov 2015.
Material and Methods: A total of 60 patients with per operative findings of perforated appendix were included in
the study. They were divided into 02 groups based on the wound closure technique. Group A included patients
who had their wound closed primarily with an abdominal drain along with a subcutaneous radevac drain
whereas group B included patients who had their wound closed by delayed primary closure technique. Both the
groups were compared in terms of frequency of postoperative surgical site infection. Outcome was measured in
terms of postoperative surgical site infection. Data was analyzed using SPSS 21.0. Post stratification chi-square
test was applied and p-value was calculated for each variable.
Results: The mean age of patients included in group A was 40 ± 24.5 yrs and those in group B was 35 ± 19.5 years.
Group A included 17 (56.7%) male patients and 13 (43.3%) female patients. The number of male patients in
group B were 18 (60%) and females were 12 (40%) respectively. Each of the groups had 02 (6.7%) diabetic patients.
Group A had 02 (6.7%) patients who had BMI greater than 25 whereas group B had 01 (3.3%) patient with BMI
greater than 25. In the study, 13 patients had postoperative surgical site infections. Group A had 03 patients (10%)
and group B had 10 patients (33.3%) (p=0.025) who had postoperative surgical site infection which proved that
primary wound closure with subcutaneous drain is better than delayed primary wound closure in patients with
perforated appendicitis.
Conclusion: Primary wound closure with a subcutaneous Radevac drain was found more effective than delayed
primary wound closure in prevention of postoperative surgical site infection in patients with per operative
findings of perforated appendicitis.