Non-absorbable interrupted versus absorbable continuous skin closure in pediatric appendectomies.
OBJECTIVE
appendectomy wounds are still commonly closed with non-absorbable sutures. Stitch removal has financial costs and causes anxiety in children. Our aim was to compare interrupted non-absorbable (NA) and continuous intradermal absorbable (A) sutures in appendectomy wounds to evaluate whether absorbable suturing increases the risk of complications.


METHODS
198 children (age 4-18 years) including perforated cases were prospectively randomized into two groups (NA and A skin closure). The wounds and inflammatory markers were evaluated on the first two postoperative days. The appearance of the wound was evaluated one week postoperatively by a district nurse. Follow-up data were obtained from 166 patients (87 in NA group and 79 in A group).


RESULTS
in NA group 86 % and in A group 81 % had appendicitis (8 % and 15.6 % perforated and 9.3 % and 25 % gangrenous cases in NA and A groups, respectively). The total wound infection rate was low, 1.8 % (2.3 % in NA Group and 1.3% in A Group). No differences in the inflammatory markers or the appearance of the wound were noted between the groups, but nine children in NA Group (10.3 %) had a partial wound dehiscence after stitch removal.


CONCLUSIONS
appendectomy wounds in children can be closed with continuous, absorbable sutures, even in complicated cases.
Pediatric Research Centre, Medical School, Tampere University Hospital, Tampere, Finland. satu-liisa.pauniaho@uta.fi
S L
SL
Pauniaho
T
T
Lahdes-Vasama
M T
MT
Helminen
T
T
Iber
E
E
Mäkelä
O
O
Pajulo
D020341:Absorbable Implants; D000293:Adolescent; D001062:Appendectomy / Q000295:instrumentation / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013536:Suture Techniques; D013537:Sutures