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Value of intraoperative abdominal cavity culture in appendicectomy: a retrospective study
M R Moawad1, S Dasmohapatra, T Justin
1Department of Colorectal Surgery, West Suffolk Hospital, Cambridge University Teaching Hospitals Trust, Hardwick Lane, Bury St Edmunds, Suffolk IP33 2QZ, UK. mikowm@hotmail.com
Abstract:
Appendicectomy is one of the most common surgical emergency procedures. Intraperitoneal culture during appendicectomy is routine practice in some hospitals, while some surgeons advocate abandoning this routine. The aim of our study is to determine the value of intraoperative abdominal cavity culture and its impact on the patient management. Retrospective analysis was performed on 498 patients who underwent appendicectomy over 2.5-year period. The median of the postoperative hospital stay was 2 days, while the median time taken to receive culture results was 3 days. A positive culture was found in 42.6%. Approximately 42.7% of the patients were discharged from the hospital before receiving the culture results. The culture and sensitivity results altered the antibiotic regimen in one patient (0.85%). Intraoperative abdominal cavity culture results were seldom used for clinical management in patients with acute appendicitis. The traditional surgical practice of routinely culturing peritoneal fluid in these patients should be abandoned.
Insights
Routine intraoperative abdominal cavity cultures during appendicectomy (appendix removal) rarely impact patient management. This study suggests abandoning the practice of routine peritoneal fluid culturing in appendicitis cases.
Area of Science:
- Surgical Procedures
- Microbiology
- Clinical Management
Background:
- Appendicectomy is a common emergency surgical procedure.
- Intraoperative peritoneal fluid culture during appendicectomy is a debated routine practice.
- The clinical utility of routine intraoperative cultures in appendicitis management is uncertain.
Purpose of the Study:
- To evaluate the value of intraoperative abdominal cavity cultures.
- To determine the impact of these cultures on patient management in appendicectomy.
- To assess the necessity of routine peritoneal fluid culturing in acute appendicitis.
Main Methods:
- Retrospective analysis of 498 patients undergoing appendicectomy over 2.5 years.
- Evaluation of the timing of culture results versus patient discharge.
- Assessment of the influence of culture and sensitivity results on antibiotic regimens.
Main Results:
- Positive cultures were found in 42.6% of patients.
- Median postoperative hospital stay was 2 days; median time to culture results was 3 days.
- Culture results altered antibiotic regimens in only 0.85% of patients, with many discharged before results were available.
Conclusions:
- Intraoperative abdominal cavity culture results are infrequently utilized in managing acute appendicitis.
- Routine culturing of peritoneal fluid during appendicectomy offers limited clinical benefit.
- The practice of routine intraoperative abdominal cavity culturing in appendicectomy should be discontinued.
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