A COMPARATIVE STUDY BETWEEN CLOSURE VERSUS NONCLOSURE OF PERITONEUM IN OPEN APPENDICECTOMIES

Background: Acute appendicitis is one of the most common surgical emergencies. Aims And Objectives: To assess the post-operative analgesic requirement, infection rate operating time, postoperative hospital stay ,of non-closure of the peritoneum at open appendectomy as compared to suture peritonization. Design:Comparative prospective randomized study. Methods:All patients satisfying the inclusion criteria were enrolled into the study with informed consent.Patients undergoing surgery were randomized for closure and non closure of peritoneum and results computed. Results:Majority of the patients belonged to the age group of 21-30 years.closure of peritoneum took a mean time of 71 minutes and non closure of peritoneum took a mean time of 46.7minutes. The probability value (p value) obtained comes out to be 0.001 which is statistically significant.There was a high requirement of analgesics(86%) in the study group compared to just 8% in the control group. The probability value (p value) obtained comes out to be 0.001 which is statistically significant.Patients who underwent closure of peritoneum stayed in the hospital for a average of 5.2 days compared to 2.9 days in the non-closure group. The probability value (p value) obtained comes out to be 0.001 which is statistically significant. VAS in study group on D0, D1, D2 is 5.4 , 3.9 , 2.5 respectively. While in the control group VAS is D0, D1, D2 is 3.1 , 1.9 , 0.7 respectively. The probability value (p value) obtained comes out to be 0.001 which is statistically significant. A total of 10 patients in closure group(20%) and 23 patients in nonclosure group(46%) had surgical site infection. Conclusion:The study group of non-closure of peritoneum was found to be superior to closure during open appendicectomy because of- ? short duration of the procedure ? less post operative pain ? less analgesic requirement ? less number of days of hospital stay this way of treatment has been mentioned in literature as well ,we are strengthening their view with these cases. In conclusion, these results have shown that non closure of peritoneum is better than closure of peritoneum in open appendicectomies.