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Background: Appendicitis is more common during the second
and third decade of life and appendectomy scar is important in terms of
cosmetic issues. The scar is an important factor in the patient's satisfaction.
Conventional teaching has an emphasis on the closure of skin incision with
"separate" sutures. The aim of this study was to reconsider this dogma.
Methods: Among 321 patients with acute
appendicitis who came to the emergency unit of Imam Khomeini Hospital in
Tehran, Iran since april 2007
till april 2008, 278 (86.6%) patients had
uncomplicated appendicitis and were enrolled in our clinical trial. The
patients were randomly assigned to two groups of interrupted suture closure (n=139) and subcuticular
suture closure (n=139). Anesthesia method and
surgical technique were similar between the two groups. All patients were
followed up post-operatively (four weeks) for the presence of infectious
drainage, pain, erythema, swelling and warmness at the surgical site.
Results: The patients' sex and
their mean age were not statistically different between the groups. There was
no significant difference in the frequency of surgical site complications between
the two groups (five cases in the "interrupted" group and eight cases in the
"subcuticular" group p=0.415).
Conclusion: This study showed that
appendectomy incision closure with subcuticular sutures did not increase the
risk of wound complications. From the point of better cosmetic outcome of
subcuticular sutures, this method may be the method of choice for the closure
of appendectomy incisions in uncomplicated appendicitis.
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