A Comparison of Simple Ligation Appendicular Stump Versus Stump Invagination in Appendicectomy Done on Nonperforated Appendicitis in Terms of Post Operative Wound Infection - A Randomized Clinical Trial

Abstract

Background and objectives ABSTRACT Appendicectomy is one of the commonest operations in abdominal surgery. The most common method is to crush and ligate the stump and then invaginate into caecal wall by means of purse string suture. The objectives of the present study were compare and evaluate the technique of simple ligation of appendicular stump versus stump invagination and to compare the duration of post-operative hospital stay in treatment of appendicectomies in terms of post operative wound infection. Methodology The present one year randomized clinical trial was conducted in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum over a period from January 2009 to December 2009 on 60 patients with non perforated appendicitis. A total of 30 patients in each group that is simple ligation and stump invagination were allotted by simple randomization. Wound infection was identified according to the NNIS program definition. Results In the present study 43.33% were males and 56.67% were females in simple ligation and in stump invagination group both sexes equally distributed. Mean age in simple ligation group was 27.73±11.15 years compared to stump invagination group 27.40±11.99 years. All the patients ( 100% ) in this study presented with pain in right lower abdomen. On day 3 minor wound infection IV was seen in 13.33% of patients in stump invagination group compared to 6.67% in simple ligation group. On day 7, 16.67% patients had minor and 3.33% had major wound infection in stump invagination group compared to 10.00% and 3.33% simple ligation group respectively. The mean hospital stay in simple ligation group was significantly less ( 5.23 ± 3.40 days) compared to stump invagination ( 7.00 ± 3.03 days ) ( p=0.046 ) . Conclusion The study showed reduced incidence of wound infection and significantly reduced hospital stay with simple ligation compared to stump invagination during appendectomy done on non perforated appendicitis.