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Poster Display - 84
Wound closure techniques: subcuticular vs. interrupted transdermal sutures in paediatric open appendectomy – a randomized control trial
Rehman Waheed, Batool Fatima, Zuha Zafar, Zahra Auqil, Kashif Bashir
Department of Pediatric Surgery, Mayo Hospital Lahore, Pakistan
Purpose: Despite advancements in surgical practice, paediatric patients undergoing open appendectomy for complicated appendicitis continue to face a significant risk of surgical site infections (SSIs). Given the lack of consensus on the optimal skin closure method, this study is designed to evaluate and compare the effectiveness of two techniques: continuous subcuticular sutures and interrupted transdermal sutures. Our objective is to determine their respective impacts on SSI rates, scar cosmesis, and overall wound healing outcomes.
Methods: A randomized controlled trial (reg no: TCTR20250527004) was conducted from September 2024 to March 2025. Patients aged ≤12 years with complicated appendicitis were enrolled and randomized into two equal groups: Group A (subcuticular continuous closure) and Group B (interrupted transdermal closure). Outcome measures included incidence of SSI, wound dehiscence, and Manchester Scar Score, followed upto 30th post operative day.
Results: SSI rates at one week postoperatively showed no statistically significant difference between the two groups (p=0.43). The logistic regression analysis revealed that appendicitis grade was a significant predictor of wound infection (odds ratio = 1.83, 95% CI: 1.33–2.52, p < 0.001), unlike the wound closure method (p = 0.711). Importantly, the Manchester scar score at Day 7 indicated a significantly better scar appearance in the group receiving continuous subcuticular sutures (mean 15.5 SD 3.24) compared to the interrupted transdermal group (mean 17.8 SD 2.92, p < 0.005).
Conclusion: Our study concludes that while both continuous subcuticular and interrupted transdermal suturing lead to similar SSI rates in paediatric open appendectomies, subcuticular continuous closure provides significantly better cosmetic outcomes. This makes it the preferred technique, highlighting the importance of aesthetic results for long-term patient satisfaction in children. Further multicentre studies are warranted to validate these findings and explore cost-effective alternatives.