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Open Appendectomy in Children

Medically reviewed by Last updated on Feb 6, 2023.


What you need to know about an open appendectomy:

An open appendectomy is surgery to remove your child's appendix through an incision in his or her lower abdomen.

Abdominal Organs

How to prepare your child for surgery:

  • Your child's healthcare provider will tell you how to help your child prepare for surgery. The provider will tell you which medicines your child should take or not take on the day of surgery. You may be told not to let your child eat or drink anything after midnight on the day of surgery.
  • Antibiotics may be given through your child's IV to prevent an infection during or after surgery. Tell your healthcare provider if your child has ever had an allergic reaction to antibiotics.

What will happen during surgery:

  • General anesthesia will be given to keep your child asleep and free from pain during surgery. Your child's surgeon will make an incision in your child's lower abdomen. The appendix will be removed. The incision will be closed with stitches, staples, or medical glue.
  • If your child's appendix has ruptured or pus remains inside your child's abdomen, a drain may be placed in the wound.

What will happen after surgery:

  • Your child may need to spend a few nights in the hospital. This may be needed if the appendix ruptured or your child has other medical problems.
  • Your child may be on a clear diet at first. He or she may be given ice chips and then liquids such as water, broth, juice, or soft drinks. Healthcare providers will tell you when it is okay to let your child eat regular foods.

Risks of an open appendectomy:

  • Even with surgery, your child may develop gangrene (tissue death). Your child may get a life-threatening blood infection. Organs may be damaged or push through the incision site. Scar tissue may form inside your child's body and cause tissue and organs to stick together. This may cause bowel obstruction or infertility. Your child's bowels may stop working. He or she may get an abscess (pus-filled area) that can cause infection. Another surgery may be needed to help fix some of these problems.
  • Your child may get a blood clot in his or her leg or arm. This can cause pain and swelling. The clot can also stop blood from flowing where it needs to go in your child's body. The clot can break loose and travel to your child's lungs or brain.

Seek care immediately if:

  • Blood soaks through your child's bandage.
  • Your child's incision wound is red, swollen, or has pus coming from it.
  • Your child's stitches come apart.
  • Your child has severe pain in his or her abdomen.
  • Your child's drain is loose or has fallen out.
  • You see a bulge coming out of your child's surgery site.

Contact your child's healthcare provider if:

  • Your child has a fever.
  • Your child has nausea or is vomiting.
  • You have questions or concerns about your child's condition, surgery, or care.


Your child may need any of the following:

  • Antibiotics help prevent or fight a bacterial infection.
  • Prescription pain medicine may be given. Ask your child's healthcare provider how to give this medicine safely. Some prescription pain medicines contain acetaminophen. Do not give your child other medicines that contain acetaminophen without talking to your child's healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your child's healthcare provider how to prevent or treat constipation.
  • Do not give aspirin to children younger than 18 years. Your child could develop Reye syndrome if he or she has the flu or a fever and takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin or salicylates.
  • Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell the provider if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.

Have your child rest:

Your child will need to return to his daily activities slowly and rest often. This will help protect the incision wound and prevent the stitches from coming out. Rest will help your child heal. Ask your child's healthcare provider when it is okay to let your child return to daycare, school, or other normal daily activities. Ask if sports are safe for your child.

Care for your child's incision wound as directed:

Keep the wound clean and dry. You may need to cover the wound when your child bathes so it does not get wet. When you are allowed to clean your child's wound, carefully wash it with soap and water, or as directed. Dry the area and put on new, clean bandages as directed. Change the bandages when they get wet or dirty. Check your child's wound for signs of infection, such as swelling, redness, or pus.

Care for your child's drain as directed:

Your child may go home with a drain coming out of his incision. A drain is a thin rubber tube used to remove extra fluid from your child's abdomen. Your child's healthcare provider will take the drain out when there is no more fluid coming from the incision. Ask your child's healthcare provider how to care for your child's drain. Do not remove your child's drain.

Apply ice on your child's incision wound:

Apply ice on your child's wound for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you apply it to your child's skin. Ice helps prevent tissue damage and decreases swelling and pain.

Follow up with your child's healthcare provider as directed:

Your child may need to return to have his stitches or drain removed. Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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