This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
When the development of a wound seroma is a potential problem after an appendectomy in an obese patient, the best effective method of wound management is 
Select and explain. 
A. Leaving the subcutaneous tissue and skin open to heal by secondary intention, B. Closing the wound over a rubber drain, C. Closing the wound with a closed suction drain, D. Closing the wound with multiple sutures in the subcutaneous tissue
C: Closing the wound with a closed suction drain
Answer: C: Closing the wound with a closed suction drain 
Explanation: Closing the wound with a closed suction drain With a clean-contaminated wound after an appendectomy, it should not be necessary to leave the wound open. In an obese patient, seroma in the wound is a possibility, and primary wound closure might not be appropriate. Rubber drains act as a route for bacteria to enter the wound, and multiple subcutaneous cultures provide foreign bodies as a nidus for possible infection. The best option is to close the wound carefully over a closed-suction drain. Whatever method is used, all devitalized tissue should be removed and careful hemostasis accomplished before the procedure is completed. Although wound irrigation with an antibiotic solution is frequently used, there is no solid evidence that this reduces the likelihood of wound infection.