[Use of drainage in surgery for perforated appendicitis: the effect on complications]

We aimed to investigate the use of drainage in surgery for perforated appendicitis and to determine its effect(s) on complications.

Two-hundred and eight patients diagnosed with perforated appendicitis between May 1999 and January 2009 were retrospectively evaluated in terms of using drainage with respect to surgical infections and other complications and duration of hospital stay.

A total of 208 patients diagnosed with perforated appendicitis underwent surgery. The mean age of the patients was 41.05±16.30 years. Of the 208 patients, 128 (61.5%) were male. The median duration of complaints was 2 days (1-15 days). Drainage was applied in 83 patients (39.9%). The median duration of drainage was 3 days (1-7 days). Surgical infections, wound dehiscence, other complications, and re-hospitalization rates were significantly higher in patients with drainage. The mean time from appearance of complaints to surgery, the duration of hospitalization and antibiotic treatment were also longer in the drainage group (p=0.001 for all). A higher rate of the patients with an accompanying disease (39.8%-19.2%) and midline incision (20.5%-3.2%) and of the elderly patients had drainage. Multivariate analyses showed that using a drain independently affected surgical infections (p<0.001).

It can be concluded that using a drain after surgery for perforated appendicitis increases surgical infections and in turn the duration of hospital stay.