INCIDENCE OF WOUND SITE INFECTION IN PATIENTS WITH SIMPLE AND GANGRENOUS OR PERFORATED APPENDIX AFTER PRIMARY WOUND CLOSURE: A STUDY IN SURGICAL UNIT HAYATABAD MEDICAL COMPLEX

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Abstract

Objective: To determine the incidence of surgical site infection in patients after primary closure with perforated or
gangrenous and simple appendicitis.
Background: Appendectomy is the most commonly performed procedure in surgical emergency departments throughout
the world .After appendectomy most surgeons nowadays prefer primary delayed closure in patients having gangrenous
or perforated appendicitis .Usual outcome is more post operative pain as well as prolong hospital stay resulting in
increase hospital costs which is a matter of big concern in this part of the world .there is an ongoing debate regarding
primary wound closure in these patients without an obvious consensus yet .Usually in this hospital the wound is left
open for primary delayed wound closure. In this study our aim was to compare the incidence of wound infection in
patients having simple appendicitis to those who had gangrenous or perforated appendix after performing primary
closure in both groups.
Meteriel and Methods: This study was conducted in surgical unit Hayatabad Medical Complex Peshawar.In this
observational study a total of 356 patients were included, in which 178 patients (half of total) were of gangrenous or
perforated appendicitis and 178 patients (half of total) were simple appendicitis. Wounds of all patients in both groups
were closed by choosing primary wound closure method. Follow up was carried out for a time period of 30 days in all
patients after surgery. Data of the patients such as age,gender,operating time,histopathologic report,culture/ sensitivity
report and wound infection were all gathered. A comparison between the studied groups was made using Student’s
t-test for continuous variables and χ2 test for categorical variables.
Results: The median age of the patients was 22 years. There were 118 (33.4%) females and 238 (66.6%) males. The
median operating time was 32 minutes. Wound infections were observed in 21 patients (5.8%), including 8 cases of
simple and 13 cases of gangrenous or perforated appendicitis which was not statistically significant.
Conclusion: There was no statistically significant difference in wound infection between the simple and gangrenous
or perforated appendicitis groups.
Key Words: Primary wound closure, Delayed wound closure, Simple and gangrenous or Perforated appendicitis,wound.

Authors: 
Zafar Iqbal
Gul Shareef
Gulab Noor
Aziz ullah
Irfan Ul Islam Nasir1

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