Background :
Appendicular abscesses are a common complication of acute appendicitis, often requiring surgical drainage. The optimal method of skin closure after drainage remains debated. This study compares primary skin closure (PC) and delayed skin closure (DC) in terms of surgical site infection (SSI), hospital stay, wound healing time, and patient satisfaction.
Methods :
A single-blind randomized controlled trial was conducted on 200 patients with appendicular abscesses confirmed via ultrasound or CT scan. Patients were randomized to PC (immediate closure) or DC (closure after 48 hours of open packing).
Outcomes included SSI rates (CDC criteria), hospitalization duration, time to complete healing, and patient-reported outcomes.
Results :
The DC group had significantly lower SSI rates (8% vs. 18%, p=0.02) but longer hospital stays (5.8 vs. 3.2 days, p<0.001) and healing times (14.5 vs. 10.2 days, p=0.01).
Diabetic patients in the PC group had a 30% SSI rate compared to 12% in the DC group (p=0.04). Patient satisfaction was higher in the PC group due to faster recovery.
Conclusion :
Delayed closure reduces SSI risk, particularly in high-risk populations, but prolongs recovery. Primary closure is advantageous in low-resource settings or for patients prioritizing shorter hospitalization.