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KMID : 0371619990150010053
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Journal of Wonkwang Medical Science
1999 Volume.15 No. 1 p.53 ~ p.57
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The Effect of Saline Irrigation and Primary Closure in Perforated Appendicitis
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Lee Hwan-Bong
Lee Kang-Chang
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Abstract
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Background: Under the principle that, the more the removal of pathogens from the contaminated wound, the lesser the chance of wound infection, we tried massive saline irrigation and primary closure in order to compare with the generalized wound management method of delayed primary closure.
Methods: From September 1997 to Desember 1998, we operated 318 cases of appendicitis and 64 cases of them presented with perforated appendicitis on operative field. By the same method and the same surgeon, all patients of perforated appendicitis underwent appendectomy and had intraperitoneal closed suction drainage from the peluic cavity and massive (1.0L) saline wound irrigation after peritoneal approximation. A penrose drain was also left in primarily closed operative wound for several days in all patients.
Results: Postoperative suppurative wound infection in 5 patients (7.8%) which in eluded 2 cases of wound infections after reoperation due to intraabdominal abscesses appeared as the result of above management.
Conclusions: Because of painful time consuming method of delayed primary closure, primary closure of operative wound in perforated appendicitis seems to be acceptable as management method especially in children.
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KEYWORD
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Primary closure, Perforated appendicitis, Wound irrigation
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