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Wound closure

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Before closure, the wound is irrigated with either normal saline or a solution of aqueous betadine.

The appendicectomy wound is closed in layers:

  • peritoneum:
    • the edges of the incision are gripped with artery forceps and raised up; this is vital to ensure that the underlying bowel is not included in the closure
    • absorbable suture used
    • continuous stitching
  • transversus abdominis and internal oblique
    • closed together as one layer
    • absorbable suture
    • interrupted sutures
  • external oblique:
    • absorbable suture
    • continuous stitching
  • fat: dead space can be obliterated with a few absorbable interrupted stitches but if there was a perforation or necrotic appendix, the fat can be left open to facilitate possible drainage
  • skin: can be closed with absorbable interrupted or subcuticular stitches

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