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The optimal method for preventing abscesses in perforated appendicitis is unclear. We compared the efficacy of lavage versus aspiration for periappendicular collections/abscesses in perforated appendicitis. Our study included 286 patients. After the removal of the appendectomy material, those who underwent aspiration without prior lavage were assigned to Group I, whereas those who underwent aspiration after lavage with 500 mL physiological saline were assigned to Group II. The primary outcome measure was postoperative complications. Secondary outcome measures were intraoperative complications, morbidity, and mortality. Group I comprised 174 patients (60 female and 114 male; mean age 34.47±17.40 y), whereas Group II comprised 112 patients (39 female and 73 male; mean age 36.22±18.60 y). The 2 groups were not significantly different in age, hospitalization duration, sex, abscess formation, morbidity, or mortality. Our results demonstrate that aspiration of the surgery area without prior lavage is sufficient and can be safely applied in perforated appendicitis.