Surgical site infection rate between the primary and delayed primary closure in patients with complicated appendicitis; a randomized clinical trial

Acute appendicitis is one of the common surgical emergencies. Surgical wounds after complicated (perforated/gangrenous) appendicitis are usually managed with delayed primary closure (DPC) rather than primary closure (PC); however, choos-ing of the best closure method is controversial. The aim of this study was to compare the rate of surgical site infection between the primary closure and delayed primary closure after complicated appendicitis.

This randomized clinical trial was conducted on patients who referred to the emergency department of Loghman Hakim hospital with the chief com-plaint of acute appendicitis from February 2014 to Feb 2018. The patients were divided randomly into two equal group based on the flipping coin randomization. Demographic features, the rate of surgical site infection and the hospitalization time in the primary closure and delayed primary closure groups were recorded and analyzed by the SPSS software.

Sixty-nine patients include in the final analysis. Thirty-five patients were in the primary closure group and 34 patients were in the delayed primary closure group. Surgical site infection was observed in 6 patients, including 4 patients in the primary closure group and 2 patients in the delayed primary closure group (P value = 0.66). In addition, the hospitalization period was 3.5 ± 0.42 and 5.30 ± 0.21 in the primary clo-sure and in the delayed primary closure respectively (P value = 0.001).

There are no differences between the primary closure and delayed pri-mary closure in the context of surgical site infection. However, the hospitalization time is longer in the delayed primary closure of the complicated appendicitis wound in com-pare to the primary closure.