Wound closure

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