Wound Closure Techniques: Subcuticular Vs Interrupted Transdermal Sutures in Paediatric Patients Undergoing Open Appendectomy for Complicated Appendicitis: A Randomized Controlled Trial: Wound Closure Techniques: Subcuticular vs Transdermal Sutures in Children

Muhammad Rehman Waheed; Batool Fatima; Syed Salman Hussain Zaidi; Zuha Zafar; Babar Shahzad; Zahra Auqil; Muhammad Kashif Bashir; Muhammad Azam

doi:10.54393/pjhs.v7i1.3499

Authors

Muhammad Rehman Waheed Department of Paediatric Surgery, King Edward Medical College, Mayo Hospital, Lahore, Pakistan
Batool Fatima Department of Paediatric Surgery, Mayo Hospital, Lahore, Pakistan
Syed Salman Hussain Zaidi Department of Paediatric Surgery, Mayo Hospital, Lahore, Pakistan
Zuha Zafar Department of Paediatric Surgery, Mayo Hospital, Lahore, Pakistan
Babar Shahzad Department of Paediatric Surgery, Mayo Hospital, Lahore, Pakistan
Zahra Auqil Department of Paediatric Surgery, Mayo Hospital, Lahore, Pakistan
Muhammad Kashif Bashir Department of Paediatric Surgery, Mayo Hospital, Lahore, Pakistan
Muhammad Azam Department of Paediatric Surgery, Mayo Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v7i1.3499

Keywords:

Complicated Appendicitis, Interrupted Transdermal, Continuous Subcuticular, Surgical Site Infections, Scar

Abstract

Paediatric patients who undergo open appendectomy for complicated appendicitis face risks of surgical site infections (SSIs) and poor wound healing. Objectives: To compare continuous subcuticular versus interrupted transdermal sutures to determine their effects on SSI rates, scar cosmesis, and overall wound healing. Methods: A randomized controlled trial (TCTR20250527004) was conducted from September 2024 to March 2025, enrolling patients aged ≤12 with complicated appendicitis. Patients of both genders aged up to 12 years presenting to the paediatric surgery emergency with acute appendicitis grade 2 and above. Patients were randomized equally into two groups: Group A (continuous subcuticular closure) and Group B (interrupted transdermal closure). Primary outcomes were SSI, wound dehiscence, and Manchester Scar Scores up to 30 days post-op. Statistical analysis was done using SPSS version 23.0, with t-tests and logistic regression. Results: A total of 112 patients were included in the study, with 56 in each group. The mean number of patients with surgical site infection (SSI) in group A was 1.30 ± 0.46, and in group B mean SSI was 1.37 ± 0.49, with a p value of 0.43. However, the grade of appendicitis was a significant predictor of infection, with higher grades correlating with increased odds of infection (OR=1.83, p<0.001). The Manchester scar score showed that Group A had a mean of around 15.5+3.24 versus Group B mean of about 17.8 ± 2.92, p-value <0.005. Conclusions: The current study concludes that while both continuous subcuticular and interrupted transdermal suturing led to similar SSI rates.

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