Abstract

Objective: To determine the prevalence and risk factor of acute appendicitis in patients present for an abdominal ultrasound at Northwest General Hospital (NWGH) Peshawar. To compare the gender and age group more risk factor is present and to take frequencies of risk factors.

Methods: This open-label randomized control trial was conducted at Dr. Ruth K.M. Pfau Civil Hospital, Karachi, Pakistan from October 2020 to March 2021. Seventy-five patients were randomized to interventional (n=36, 48%) and control group (n=39, 52%) through sealed envelopes. Diluted solution was prepared by adding 30cc of Ringer’s lactate and 10cc of lignocaine 2%, with 1cc of adrenaline of 1:200000 with 200 ml of normal saline solution. Solution for control group was containing only normal saline. Following the skin harvesting at donor site, a gauze piece soaked with tumescent solution was applied at the donor site wound. Bleeding severity and epithelialization were assessed. Data was recorded in a pre-designed Performa and analyzed through SPSS version-25.

Results: There was no significant differences in baseline characteristics like age (p=0.823), gender (p=0.984) and nature of injury (p=0.936) among two groups. Severe, moderate and mild bleeding was noted in 20/39 (51.3%), 15/39 (38.5%) and 4/39 (10.3%) cases in control group as compared to 0/36 (0%); 2/36 (5.6%) and 25/36 (69.4%) cases in interventional group respectively (**<0.001). No bleeding was noted in 9/36 (25%) cases of interventional group. Complete epithelialization was observed in 24/36 (66.7%) and 17/39 (43.6%) cases in adrenaline and control groups respectively (p=0.045).

Conclusion: Application of adrenaline was more effective in bleeding control and early epithelialization at donor site following the skin harvesting as compared to conventional technique.

Clinical trials registry number: NCT04590638