The safety and efficacy of intra-abdominal drainage following open appendectomy in patients with perforated appendicitis: A prospective cohort study

Sadeghi Hassan Abadi, Hossein; Naghavi Ravandi, Marzieh; Davoudabadi, Abdoulhossein; Abdolrahim Kashi, Esmaeel; Fayyazi, Emad

doi:10.48307/FMSJ.2025.29.5.506

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Volume 29, Issue 5 (Bimothly 2025)

Feyz Med Sci J 2025, 29(5): 506-516

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The safety and efficacy of intra-abdominal drainage following open appendectomy in patients with perforated appendicitis: A prospective cohort study

Hossein Sadeghi Hassan Abadi

, Marzieh Naghavi Ravandi

, Abdoulhossein Davoudabadi

, Esmaeel Abdolrahim Kashi

, Emad Fayyazi ^*

Department of General Surgery, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran , emad.fayyazi@gmail.com

Abstract: (382 Views)

Background and Aim: Perforated appendicitis is a common surgical emergency associated with significant postoperative complications. This study was conducted to compare the outcomes of routine intra-abdominal drainage versus non-drainage following open appendectomy in these patients.
Methods: In this prospective cohort study conducted between 2021 and 2024 at Shahid Beheshti Hospital in Kashan, 220 patients with perforated appendicitis were allocated to two groups: those receiving an intra-abdominal drain (n=108) and those without a drain (n=112). Primary outcomes included the incidence of intra-abdominal abscess, surgical site infection (SSI), and postoperative bowel obstruction. Secondary outcomes included the length of hospital stay and the need for antibiotic therapy.
Results: An intra-abdominal abscess was observed in 18.5% of patients in the drain group, whereas no cases were reported in the non-drain group (P = 0.001). The rate of SSI was 11.1% in the drain group and 21.4% in the non-drain group (P = 0.036). Postoperative bowel obstruction occurred in 8 of 108 patients (7.4%) in the drain group, while none of the patients in the non-drain group developed this complication (P = 0.003). The mean length of hospital stay was 9.0 ± 3.1 days in the drain group, significantly longer than the 4.8 ± 0.9 days in the non-drain group (P < 0.001). The mean duration of postoperative antibiotic therapy was, on average, 4.5 ± 6.3 days longer in patients with an intra-abdominal drain compared to those without (P < 0.001).
Conclusion: Although the use of intra-abdominal drainage was associated with a reduction in surgical site infection, it was correlated with more serious complications, including intra-abdominal abscess and bowel obstruction, as well as a prolonged hospital stay. The routine use of drain in these patients is not recommended, and further studies are warranted to determine the optimal conditions for its selective application.

Keywords: Intra-abdominal drainage, Open appendectomy, Perforated appendicitis, Intra-abdominal abscess, Surgical site infection

Full-Text [PDF 385 kb] (34 Downloads)

Type of Study: Research | Subject: General
Received: 2025/08/5 | Revised: 2025/11/4 | Accepted: 2025/10/8 | Published: 2025/11/3

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Sadeghi Hassan Abadi H, Naghavi Ravandi M, Davoudabadi A, Abdolrahim Kashi E, Fayyazi E. The safety and efficacy of intra-abdominal drainage following open appendectomy in patients with perforated appendicitis: A prospective cohort study. Feyz Med Sci J 2025; 29 (5) :506-516
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