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Are routine peritoneal fluid cultures during appendicectomy justified?
1Department of General Surgery, North Hampshire Hospital, Basingstoke, UK. Mkhan702@aol.com
Irish Journal of Medical Science
|September 13, 2007
Summary
Routine peritoneal fluid cultures during appendicectomy do not significantly impact patient management or clinical outcomes. This study found limited changes in antibiotic selection based on culture results in appendicitis cases.
Area of Science:
- Surgical Microbiology
- Clinical Outcomes Research
Background:
- Appendicectomy is a common surgical procedure.
- The utility of routine peritoneal fluid cultures during appendicectomy is debated.
Purpose of the Study:
- To evaluate the impact of routine peritoneal fluid cultures during appendicectomy on treatment decisions and patient outcomes.
- To assess the contribution of intraoperative peritoneal cultures to the management of appendicitis.
Main Methods:
- A retrospective review of 137 consecutive appendicectomy patients over one year.
- Analysis of peritoneal fluid culture results, antibiotic selection, and clinical outcomes.
- Patients were stratified into uncomplicated (Group I) and complicated (Group II) appendicitis.
Main Results:
- Cultures were positive in 28.3% of uncomplicated and 69% of complicated appendicitis cases.
- Complications in Group II included wound infection (5.6%), prolonged ileus (7.5%), and intra-abdominal abscess (3.7%).
- Antibiotic regimens were modified in only 3 out of 109 patients.
Conclusions:
- Intraoperative peritoneal fluid cultures during appendicectomy offer limited benefit to patient management.
- The routine use of peritoneal cultures in appendicectomy does not significantly alter clinical decision-making or outcomes.
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