Efficacy Study of Delayed Primary Closure to Reduce Rate of Wound Infection in Complicated Appendicitis

Inclusion criteria 1. Adult patients age 18 years or older 2. Have been diagnosed as gangrenous or ruptured appendicitis base on clinical criteria with the following conditions a.Gangrenous appendicitis i.Erythematous or swelling of appendix and ii.Appearance of necrotic wall (dark, grayish color) b.Ruptured appendicitis i. Erythematous or swelling of appendix and ii.Appearance of hole in an appendix or iii.Rupture of appendix during a procedure c.Appearance of frank pus 3. Non-immunocompromised hosts which include 1. AIDS 2. History of end-stage renal disease (ESRD) 3. History of autoimmune disease (SLE) 4. Taking immunosuppressive agents (e.g, steroids, Cyclophosphamide, Tacrolimus, Mycophenolate mofetil) 5. Cirrhosis with ascites 6. Morbid obesity (BMI \> 40 kg/m2) 4. Non-pregnant women 5. Willing to participate and provide written informed consent