Outcome of Intra-Abdominal Drainage after Open Appendectomy for Complicated Appendicitis: A Randomized Controlled Study.

Abstract

Acute appendicitis is the most common cause of acute abdomen necessitating surgical intervention. Prophylactic drainage is commonly used in surgical practice, as in gangrenous or perforated appendicitis. Aim of the study was to discriminate the safety and efficacy of intra-abdominal drainage versus no drainage after open appendectomy for complicated appendicitis. This randomized controlled study was done among 200 cases from the period of October 2016 to September 2017 in the Department of Surgery, Mymensingh Medical College and Hospital, Mymensingh, Bangladesh. Two hundred (200) patients with complicated appendicitis were enrolled in this randomized controlled study. They were divided into two groups- the drainage and non-drainage group. Detailed information was obtained in each case according to protocol. Data was collected from the patients admitted to the surgery department in MMCH undergone appendectomy for complicated appendicitis which was classified, edited, coded and entered into the computer for statistical analysis by using SPSS. In this study 200 patients were enrolled where their age range was 11-75 years with a mean age was 31.61±15.66 years, the highest incidence was in the age group 11-20 years, 122 were males and 78 were females with male to female ratio 1.56:1. One hundred (100) patients out of the 200 patients had been drained at the operation while in 100 patients the wound was closed without drainage. In this study patients' return to their normal activities was 10.46±2.87 days in the drainage group compared to 8.70±2.07 days in the non-drainage group. Intra-abdominal drains were placed in 100 cases and were removed an average of 2.36±2.88 days after surgery. The drained group showed postoperative wound infection in 21.0% of patients while the non-drained group showed wound infection in 9.0% of patients with a p value <0.05. Twenty three percent (23.0%) of patients with drainage group and 10.0% of patients were done ultrasonographic examination and a p-value <0.05. Postoperative complications were less in the non-drainage group than in the drainage group, for this prophylactic drainage should be reconsidered.