What is Open Appendectomy

Open appendectomy is a procedure to remove the appendix through one large surgical cut (incision). The appendix is a finger-like structure that is attached to the large intestine.

An appendectomy may be done to prevent an inflamed appendix from bursting (rupturing). It also may be done to treat the infection from an appendix that has ruptured. It is usually done immediately after inflammation of the appendix (appendicitis) is diagnosed.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• The formation of collections of pus (abscesses).
• Long-lasting pain or scarring at the incision sites or inside the abdomen.
• Blood clots in the legs.

What happens before the procedure?

• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be given antibiotic medicine to help prevent infection or to treat existing inflammation or infection.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins. You will receive medicine and fluids through this tube.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
  • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic).
• A tube may be placed through your nose into your stomach to drain any stomach contents.
• A tube may be placed through the opening where urine passes into the bladder to drain urine.
• An incision will be made in the lower right side of your abdomen.
• Your appendix will be removed.
• The abdomen will be washed out to remove bacteria.
• The incision will be closed in several layers with stitches (sutures), staples, or adhesive strips.
• A bandage (dressing) may be used to cover the incision.
• If a tube was inserted into your bladder or stomach, it will be removed.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You will be given pain medicine as needed to keep you comfortable.
• If your appendix did not rupture, you may be able to go home the same day as your surgery.
• Do not drive for 24 hours if you received a sedative.
• If your appendix ruptured:
  • You will get antibiotic medicine through an IV tube.
  • You may be sent home with a temporary drain.

Open Appendectomy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• A decrease in your energy level.
• Pain in the area where the surgical cut (incision) was made.
• Constipation. This can be caused by pain medicine and a decrease in your activity.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not drive for 24 hours if you received a sedative.
• Do not drive or operate heavy machinery while taking prescription pain medicine.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

Activity

• Gradually return to your regular activities.
• For 3 weeks or as long as told by your health care provider:
  • Do not lift anything that is heavier than 10 lb (4.5 kg).
  • Do not play contact sports.

Bathing

• Keep your incision clean and dry.
  • Gently wash the incision with soap and water.
  • Rinse the incision with water to remove all soap.
  • Pat the incision dry with a clean towel. Do not rub the incision.
• You may take showers after 48 hours.
• Do not take baths, swim, or use hot tubs for 2 weeks or as long as told by your health care provider.

Incision care

• Follow instructions from your health care provider about caring for your incision. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. In some cases, these skin closures may need to be in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips entirely unless your health care provider tells you to remove them.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Other Instructions

• If you were sent home with a drain, follow instructions from your health care provider about how to care for the drain and how to empty it.
• Take deep breaths. This helps to prevent your lungs from becoming inflamed.
• To relieve and prevent constipation:
  • Drink plenty of fluids.
  • Eat plenty of fruits and vegetables.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain at the site of your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision or dressing.
• Your incision edges break open after your sutures have been removed.
• You have increasing pain in your shoulders.
• You feel dizzy or you faint.
• You develop shortness of breath.
• You keep feeling nauseous or you are vomiting.
• You have diarrhea or you cannot control your bowel functions.
• You lose your appetite.
• You develop swelling or pain in your legs.

Get help right away if:

• You have a fever.
• You develop a rash.
• You have difficulty breathing.
• You have sharp pains in your chest.