Comparative Outcomes of Immediate and Delayed Wound Closure Techniques in Appendectomies for Gangrenous Appendicitis

Abstract

Background: Post-operative medical complications are very common in patients with gangrenous nonperforated appendicitis, especially surgical site infections (SSIs). Currently no conclusive answers on the relative benefits of immediate vs delayed wound clear therefore a comparison is essential. Objectives: In order to compare the results of immediate versus delayed wound closure in patients with gangrenous appendicitis who underwent appendectomy, SSIs, wound healing, and general postoperative recovery will be assessed. Methodology: The present study is a retrospective cohort study, using data from 185 patients, operated for gangrenous appendicitis during the period between from January 2023 to February, 2024. Total patients were categorized into two groups based on the wound closure technique employed, immediate wound closure (IWC, n=105) and delayed wound closure (DWC, n=80). Specific dependent variables were the overall SSI rate, days to wound healing and days of hospitalization. Secondary endpoints included a return of symptoms and overall postoperative morbidity. Results: The study also revealed that the incidence of SSIs was relatively low in the DWC group at 8. 0% compared to the (22.0± 0.01) % in the IWC group, which was statistically significant (p<0. 001). The overall IWC time was significantly shorter in the IWC group (11 days) as compared to the DWC group (15 days) (P value = 0. 02). In our study, the DWC group was found to have a lower median LOS of 6 days as compared to IWC group that had a LOS of 8 days. When compared the two groups regarding readmission rates, the difference was not statistically significant (p-value = 0. 05). Conclusion: These delayed wound closure strategies in appendectomy for gangrenous appendicitis are a safe means of decreasing SSIs and hospital stay without a predisposing effect on wound healing and readmission. Based on these findings, it is recommended that DWC is the better approach in the management of such high-risk surgical patients.