Does delay in appendectomy affect surgical site infection in children with appendicitis?

Area of Science:

• Pediatric surgery
• Infectious disease epidemiology

Background:

• Surgical site infection (SSI) is a common complication after pediatric appendectomy.
• The impact of the time interval from diagnosis to operation on SSI risk in children remains incompletely understood.

Purpose of the Study:

• To investigate the association between the time from diagnosis to operation and the occurrence of surgical site infection (SSI) in pediatric patients undergoing appendectomy.

Main Methods:

• Retrospective analysis of 1388 pediatric patients who underwent appendectomy between 2010 and 2012.
• Data collected included patient demographics, symptom duration, presentation and admission times, antibiotic administration, operative findings, and SSI occurrence.
• Statistical analysis examined the relationship between time intervals (triage to operation, admission to operation) and SSI, controlling for other variables.

Main Results:

• Overall SSI rate was 5.1%, with 1.4% for simple appendicitis (SA) and 12.4% for complex appendicitis (CA).
• No significant increase in SSI risk was observed with increased time from ED triage to operation or from admission to operation.
• Longer symptom duration, obesity, and elevated admission white blood cell (WBC) count were associated with increased SSI risk in univariable analysis, while only CA remained a significant risk factor in multivariable analysis.

Conclusions:

• The timing of appendectomy in children is not significantly associated with an increased risk of surgical site infection.
• Longer symptom duration and complex appendicitis are key risk factors for SSI in this population.
• Further multi-institutional studies are warranted to validate these findings.