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Controversial aspects of appendicitis management in children
Archives of Surgery (Chicago, Ill. : 1960)
|July 1, 1981
Summary
For perforated appendicitis in children, use gentamicin and clindamycin antibiotics. Drains should be used sparingly, and delayed primary closure is recommended for all perforation cases to improve outcomes.
Area of Science:
- Pediatric surgery
- Infectious disease management
Background:
- Controversies exist in pediatric appendicitis management, specifically regarding antibiotic selection, peritoneal drainage, and surgical incision closure.
- Optimizing treatment protocols for perforated appendicitis is crucial for reducing complications.
Purpose of the Study:
- To provide evidence-based recommendations for antibiotic usage, peritoneal drainage, and incision closure in pediatric appendicitis, particularly in cases of perforation.
Main Methods:
- Analysis of results and bacteriologic data from pediatric appendicitis cases.
- Evaluation of outcomes associated with different management strategies for perforated appendicitis.
Main Results:
- Gentamicin sulfate and clindamycin phosphate are suggested for routine use in suspected perforations.
- Selective and limited use of drains is deemed appropriate.
- Delayed primary closure is recommended for all cases involving perforation.
Conclusions:
- Routine use of gentamicin and clindamycin is supported for perforated appendicitis in children.
- Judicious use of drains and consistent application of delayed primary closure are advised.
- These strategies aim to optimize the management of complicated appendicitis in pediatric patients.