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