Standardized irrigation technique reduces intraabdominal abscess after appendectomy

Area of Science:

• Surgical Outcomes
• Infectious Disease Epidemiology
• Gastrointestinal Surgery

Background:

• The utility of irrigation during appendectomy for acute appendicitis remains debated.
• Recent studies have questioned the benefit of irrigation in appendectomy procedures.
• Practices varied, with irrigation being surgeon-dependent or standardized.

Purpose of the Study:

• To retrospectively assess if a standardized large volume irrigation technique reduces intraabdominal infections after appendectomy.
• To compare infection rates between standardized irrigation and non-standardized irrigation methods.
• Hypothesis: No difference in intraabdominal infection rate between the two techniques.

Main Methods:

• Retrospective review of 432 appendectomy cases for acute appendicitis (2007-2017).
• Comparison of subsequent abdominal infection rates between standardized large volume irrigation and other techniques.
• Fisher's exact test used for statistical comparison (p < 0.05 significant).

Main Results:

• No subsequent abdominal infections (0/140) occurred with standardized large volume irrigation.
• A 6.2% infection rate (18/292) was observed in patients without standardized irrigation (p=0.001).
• For perforated appendix cases, infection rates were 0% (0/31) vs. 18.9% (14/74) (p=0.009).

Conclusions:

• Standardized large volume irrigation is associated with significantly lower rates of subsequent abdominal infection.
• The benefit was observed even in cases involving a perforated appendix.
• Prospective studies are recommended to further evaluate this irrigation technique.