Comparison of Primary Wound Closure with Vacuum Drainage and Delayed Closure in Perforated Appendicitis

Open wound managment after perforated appendicitis has been a common practice but recently, primary closure has been advocated to reduce costs and morbidity. For comparing delayed closures against primary closure with vacuum drainage, a randomized experimental study was designed. in Kerman. Sixty patients with perforated appendicitis divided randomly in two groups and evaluated on day of discharge and 30 days after discharge for complications and morbidity. In first group, wound wasn't closed for 3 days and then closed. In second group, wound was closed after homeostasis and irrigation and then a vacuum drain was seprately fixed in wound. In all of the patients type of injected antibiotic was the same. There wasn't any statistically significant difference between the two groups about sex and age. But there was statistically significant difference in duration of hospitalization, and vacuum drainage group had lower hopitalization (Pv= 0.002). None of the cases in both groups had any complication. Primary closure with vacuum drainage after appendectomy for gangrenous or perforated appendicitis combined with the use of antibiotic therapy in the perioperative period is not associated with an increased risk of incision infection when compared with delayed closure.Primary closure of perforated appendicitis wound with vacuum drain is recommonded because of its cost benefit and no additional complication for wound.