The skin is closed with staples if contamination has not been excessive and the risk of wound infection is not a major concern (eg. immunocompromised patient). If there is significant concern about wound infection, the wound is left open for later closure (delayed primary closure). Untied skin sutures may be left for this purpose. The rule for most suppurative or perforated appendices used to be to leave the wound open. In this era of perioperative antibiotics, very few closed appendectomy incisions develop infection.