The use of drains and delayed closure of the operative wound in children with complicated appendicitis

Abstract

Introduction. There is evidence that not using intracavitary drains in the management of acute appendicitis, as well as performing primary closure of the surgical wound in these cases, does not lead to an increase in post-surgical complications. Objective. To describe the development of complications and hospital indicators in two groups of patients with acute appendicitis, one group with drains and secondary closure of the surgical wound, and another group without drains and with primary closure. Methodology. Descriptive cross-sectional study. 498 files of children diagnosed with acute appendicitis were reviewed. Of these, 156 were included in the study. Two analysis groups were formed. The first described the use of abdominal drains and the second related to the closure of the surgical wound. Morbidity and hospital indicators were compared. Results. Significant differences were found in the need for reoperation (-7.3) and in the value of some hospital indicators: use of antibiotics (-0.48), use of parenteral analgesics (-0.49), initiation of oral feeding (-0.35), and hospital stay (-0.59); which were lower in the primary closure group. However, no significant differences were found in the use of postoperative drains. Conclusion. Secondary closure of the surgical wound favors reoperation and increases hospital indicators.