There were no significant differences between the two groups in the rates of intra-peritoneal abscess or wound infection .
It is not clear whether routine abdominal drainage has any effect on the prevention of intra-peritoneal abscess after open appendectomy for complicated appendicitis .
Abdominal drainage after an emergency open appendectomy may be associated with delayed hospital discharge for patients with complicated appendicitis
BACKGROUND Appendectomy , the surgical removal of the appendix , is performed primarily for acute appendicitis .
Patients who undergo appendectomy for complicated appendicitis , defined as gangrenous or perforated appendicitis , are more likely to suffer from postoperative complications .
The routine use of abdominal drainage to reduce postoperative complications after appendectomy for complicated appendicitis is controversial .
OBJECTIVES To assess the safety and efficacy of abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis .
Management strategy for dirty abdominal incisions: primary or delayed primary closure? A randomized trial.
BACKGROUND AND PURPOSE It is still a matter of debate whether delayed primary closure ( DPC ) of dirty abdominal incisions reduces surgical site infections ( SSIs ) compared with primary closure ( PC ) . Our objective was to determine whether DPC of dirty abdominal incisions reduces SSIs . METHOD A controlled r and omized study was conducted at an academic tertiary care 1,500-bed university hospital in Western India involving 81 consecutive patients with dirty abdominal incisions . Only 77 patients ( DPC = 37 , PC = 40 ) were evaluable because of the deaths of four patients . A total of 52 patients had peptic or typhoid perforations , whereas the rest had appendicular perforations/abscesses , penetrating or blunt abdominal injuries with gastrointestinal perforation , or intra-peritoneal abscesses . Patients were r and omized to have their surgical incisions ( skin and subcutaneous tissue ) either closed primarily ( PC ) or left open with saline-soaked gauze dressings for DPC on the 3(rd ) postoperative day or later if the incision conditions were inappropriate for closure . The main outcome measure was the incidence of postoperative SSI . RESULTS In the entire series , SSI developed after incision closure in 23 % of the patients . Infections were significantly more common in the PC group ( 42.5 % vs. 2.7 % for DPC ; p = 0.0000375 ) . There also were significantly more cases of abdominal dehiscence in the PC group ( DPC 1 [ 2.7 % ] vs. PC 10 [ 25 % ] ; p = 0.005 ) . The mean complete incision healing ( CIH ) time and length of hospital stay ( LOS ) were longer after PC ( 18.52 days ) than DPC ( 13.86 days ) , result ing in a significant difference in the end point of healing and LOS ( p = 0.0207 ) . Short-term cosmetic results for PC incisions were significantly inferior to those for DPC ( p = 0.03349 ) . CONCLUSIONS Delayed primary closure is a sound incision management technique that should be utilized for dirty abdominal incisions . It significantly lowers the rate of superficial SSI as well as fascial dehiscence and reduces the mean CIH time and hospitalization . The short-term cosmetic appearance is superior
There were no significant differences between the two groups in the rates of intra-peritoneal abscess or wound infection .
It is not clear whether routine abdominal drainage has any effect on the prevention of intra-peritoneal abscess after open appendectomy for complicated appendicitis .
Abdominal drainage after an emergency open appendectomy may be associated with delayed hospital discharge for patients with complicated appendicitis
BACKGROUND Appendectomy , the surgical removal of the appendix , is performed primarily for acute appendicitis .
Patients who undergo appendectomy for complicated appendicitis , defined as gangrenous or perforated appendicitis , are more likely to suffer from postoperative complications .
The routine use of abdominal drainage to reduce postoperative complications after appendectomy for complicated appendicitis is controversial .
OBJECTIVES To assess the safety and efficacy of abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis .