Use of Wound-Protection System and Postoperative Wound-Infection Rates in Open Appendectomy: A Randomized Prospective Trial

Objective: To determine if use of a wound-protection system in open appendectomy decreases the rate of wound infection. Design: A randomized prospective trial. Setting: A community hospital. Patients: One hundred nine patients undergoing open appendectomy. Intervention: Randomly assigned conventional retraction or retraction with the wound-protection system. Patients were blinded to the study arm in which they were enrolled. All patients were given standardized preoperative antibiotics. Demographics including age, sex, body mass index, history of diabetes, and tobacco use were recorded. The severity of appendicitis as determined by the attending surgeon at the time of operation was also noted. Main Outcome Measures: Incidence of wound infection at 21 days postoperatively Results: Of the 48 patients enrolled in the traditional retraction arm, there were 7 (14.6%) documented wound infections. Of the 61 patients enrolled in the wound-protection device arm, there was 1 (1.6%) wound infection. The severity of appendicitis between the 2 groups was matched. The decrease in incidence of wound infection observed with the wound-protection system was significant (P=.02). Conclusion: Use of a wound-protection system reduces the incidence of surgical wound infection in open appendectomy.