SUPERFICIAL SURGICAL SITE INFECTION IN DELAYED PRIMARY VS PRIMARY WOUND CLOSURE IN COMPLICATED APPENDICITIS-Open label Randomised Control Trial

1.1 BackgroundWound infection is the most common post-op complication encountered after open appendectomy. Various studies comparing risk of superficial surgical site infection (SSI) in primary closure (PC) and delayed primary closure (DPC) of wound has been conducted in the past. But there is no uniform consensus regarding the method of wound closure. So aim of this study was comparison of both wound closure techniques.1.2 Material and MethodsThis was prospective study, enrolled 50 patients who underwent open appendectomy. Patients’ demographics, characteristics and operative findings were recorded. Those who were elder than 18 years and had appendectomy with a right lower quadrant incision were included. Patients with any comorbidity, morbid obesity and pregnancy were excluded. Patients were randomized to undergo two techniques of wound closure namely PC and DPC. On follow-up at one week and one month, SSI, post-op pain and LOS were compared among two groups. Clinical assessment included a visual analog scale (1-10) for pain.1.3 ResultsIn our study incidence of SSI in DPC group was significantly lower when compared to PC group (p value=0.0002) while post-op pain and LOS was not significant on comparison between two groups. 1.4 ConclusionWe concluded that DPC was superior to PC of wound in terms of reduction of incidence of superficial SSI. Although with respect to LOS and post-op pain the two techniques of wound closure were not different.Keywords: Superficial Surgical Site Infection, Primary Closure, Delayed Primary Closure, Complicated Appendicitis.