Comparison of Wound Pain After Appendectomy Via an Alternate Incision Versus Appendectomy Via a Pararectal Incision

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 33; no. 3; pp. 529 - 533
• Main Authors: Nishio, Kenji, Ito, Hiroaki, Shimada, Jin, Yoshida, Yutoku, Otsubo, Takehito, Negishi, Hiroyuki, Koizumi, Satoshi, Noda, Akiyoshi
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 31.03.2013; 日本腹部救急医学会
• Subjects: 交叉切開; 傍腹直筋切開; 虫垂炎; 術後疼痛
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem.33.529

Purpose: We compared the degree of wound pain after appendectomy through an alternate incision (AI) with that after appendectomy through a pararectal incision (PI). Subjects: The subjects of this study were patients who had undergone appendectomy via an AI or PI at our hospital. Patients who were under 25 y of age, had abscesses, and/or had difficulty in communicating were excluded from the study. Out of the 45 subjects of this study, 24 had undergone appendectomy via an AI (AI group) and 21 had undergone the surgery via a PI (PI group). Method: A questionnaire survey was carried out to evaluate the following parameters: (1) wound length, (2) wound length index (wound length ÷ body surface area), (3) total pain score calculated using the modified Prince-Henry score (mPHS), (4) days required to reach Grade B in mPHS, (5) and duration of painkiller use. Results: The wound length in the PI group was higher than that in the AI group (AI, 4.10 cm; PI, 6.64 cm; p < 0.001). The severity of the wound pain was greater in the PI group than that in the AI group (total pain score: AI, 4.29; PI, 7.81; p = 0.013; day to Grade B: AI, 2.33 days; PI, 3.62 days; p = 0.022). The duration of painkiller use was longer in the PI group than that in the AI group (AI, 1.21 days; PI, 2.88 days; p = 0.042). However, when the analysis was limited to only patients with a drain, no significant difference in the total pain score, days to development of Grade B, or duration of painkiller use was observed between the two groups. Conclusion: In order to reduce postoperative wound pain after appendectomy, surgeons should choose AI over PI as far as possible. Furthermore, drainage is no longer needed and should never be implemented?.