Does peritoneal closure increase post appendectomy pain? a randomized study from a tertiary care hospital

Background: Appendectomy for acute appendicitis is the most common urgent abdominal surgical procedure. Closure of peritoneum tends to cause ischemia, necrosis, inflammation and foreign body reaction to the suture material resulting in more post-operative pain. This study aims to evaluate the role of no peritoneal closure technique in reduction of post-appendectomy pain. Objective: To compare the postoperative pain levels on visual analogue scale in closure versus non-closure of peritoneum in open appendectomy. Materials and Methods: This was a randomized control trial conducted at department of Surgery, Creek General Hospital Karachi, Pakistan during March 2016 till July 2018. A total of 32 patients diagnosed as having acute appendicitis presented to emergency department were included in study. Patients were randomly divided into two groups. Post-operative pain after appendectomy was measured by visual analogue score after 48-hours. Results: Mean pain scores were significantly low in group with non-closure group as compared to peritoneum closure group (p<0.005). Conclusion: Not suturing the peritoneal layers together at appendectomy has beneficial effects on post-operative pain.