Removable subcuticular skin suture in acute appendicitis: a prospective comparative clinical trial Standard surgical teaching advises the use of interrupted sutures for skin closure in potentially infected wounds.'-3 Trials supporting or refuting this premise are few. So far as we are aware no trial has been performed using a removable subcuticular stitch for skin closure in acute appendicitis. We report the results of a prospective trial to compare the two methods of skin closure. Patients, methods, and resultsOne hundred and eighty-four patients with acute appendicitis were entered into a prospective trial to compare skin wounds closed by a continuous subcuticular Prolene suture with those closed with interrupted Prolene sutures. Only patients with appendicitis subsequently confirmed histologically were included; perforation of the appendix did not contraindicate entry into the trial.All skin incisions were transverse or oblique, and the abdomen was entered through standard grid-iron or transrectus approaches. Drains (17/146; 12 %) and antibiotics (53/146; 35°%) were used at the discretion of the surgeon. Dexon was used for peritoneal and muscle closure in all cases. Neither peritoneal nor wound lavage was performed and, no topical agents were applied to the wound. After closure of the muscle layer a randomly selected sealed envelope was opened to determine the choice of skin suture. The severity of the appendicitis was classified as: (a) acute inflammation, (b) pus present, or (c) perforation. All wounds were examined daily and again two weeks after the patient left hospital; those with a discharge were considered to be infected. Skin sutures were removed between five and seven days after operation.

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