Related Experiment Videos
Summary
This study analyzed 223 acute appendicitis patients with peritonitis, finding that targeted antibacterial treatment and avoiding abdominal drains reduced hospital stays. The treatment strategy resulted in a low mortality rate of 0.4%.
Area of Science:
- Surgical Gastroenterology
- Infectious Diseases
- Critical Care Medicine
Background:
- Acute appendicitis frequently leads to peritonitis, a serious abdominal infection.
- Peritonitis management traditionally involves drainage and wound closure techniques.
- Antibiotic selection is crucial, guided by local microbial patterns.
Purpose of the Study:
- To evaluate the outcomes of treating acute appendicitis with peritonitis.
- To assess the efficacy of a tailored antibacterial regimen.
- To determine the impact of omitting abdominal drains and using delayed wound closure on patient recovery.
Main Methods:
- Analysis of 223 patients with acute appendicitis and peritonitis (51 advanced, 172 local).
- Bacteriological analysis of peritoneal exudate to guide antibiotic selection.
- Implementation of non-use of abdominal drains and provisional wound sutures.
Main Results:
- Predominant microorganisms identified were Enterobacteria and non-spore anaerobic bacteria.
- Effective antibiotic coverage included 2nd/3rd generation cephalosporins, aminoglycosides, and metronidazole.
- Omitting abdominal drains and using delayed sutures decreased hospitalization duration to 12.7 days (15.4 advanced, 11.8 local).
- A low mortality rate of 0.4% was achieved.
Conclusions:
- Targeted antibacterial therapy based on peritoneal fluid analysis is effective for appendicitis with peritonitis.
- Avoiding abdominal drains and employing provisional wound closure can shorten hospital stays.
- This approach offers a safe and effective strategy for managing complicated appendicitis, with minimal mortality.