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Post-appendectomy wound infection, a solved problem?
C van der Werken1, L P Stassen, J M van Vroonhoven
1Department of Surgery, St.Elisabeth Hospital, Tilburg, The Netherlands.
The Netherlands Journal of Surgery
|October 1, 1989
Summary
This study on acute appendicitis found that open wound treatment, combined with antibiotic prophylaxis, resulted in very low rates of wound infection and intra-abdominal abscesses. This approach was well-tolerated by patients and yielded good cosmetic outcomes.
Area of Science:
- Surgery
- Infectious Diseases
Background:
- Acute appendicitis is a common surgical emergency.
- Perforation complicates a significant number of appendicitis cases.
- Wound infection and intra-abdominal abscesses are potential complications following appendicitis surgery.
Purpose of the Study:
- To evaluate the efficacy of a specific management protocol for acute appendicitis.
- To assess the rates of wound infection and intra-abdominal abscesses.
- To determine patient acceptance and cosmetic outcomes of open wound treatment.
Main Methods:
- A 3.5-year retrospective review of 550 patients undergoing emergency surgery for acute appendicitis.
- Implementation of a strict protocol including single-dose metronidazole for antibiotic prophylaxis.
- Liberal use of open wound treatment for cases with gross contamination, involving leaving subcutaneous tissues and skin open in 218 patients.
Main Results:
- The overall wound infection rate was 1.3%.
- The intra-abdominal abscess rate was 1.1%.
- Open wound treatment was well accepted, did not prolong hospital stay, and resulted in good cosmetic outcomes.
Conclusions:
- A management protocol involving single-dose metronidazole and open wound treatment is highly effective in minimizing surgical site infections and intra-abdominal abscesses in acute appendicitis.
- Open wound management is a safe and effective strategy for contaminated appendicitis cases, offering good patient acceptance and cosmetic results.