FREQUENCY OF WOUND INFECTION IN NON-PERFORATED APPENDICITIS WITH USE OF SINGLE DOSE PREOPERATIVE ANTIBIOTICS
AbstractBackground: Antibiotics are used both pre and post-operatively in acute appendicitis for preventing wound infection. It has been observed that the routine use of post-operative antibiotics is not necessary in cases of non-perforated appendicitis as only prophylactic antibiotics are sufficient to prevent wound infection. The aim of this study was to see the frequency of wound infection in non-perforated appendicitis with single dose preoperative antibiotics only. Method: This observational study was conducted at the Department of Surgery, Ayub Medical College, Abbottabad from May to November 2014. A total of 121 patients with non-perforated appendicitis were included in the study. Only single dose preoperative antibiotics were used. The patients were followed for wound infection till 8th post-operative day. Results: 121 patients, 56(46.28%) male and 65(53.72%) female were included in the study. The mean age of patients was 27.41±7.12 years with an age range of 18 to 45 years. In the entire series, 7(5.78%) patients developed wound infection. The infection was minor which settled with conservative therapy. Prophylactic antibiotics were found efficacious in 114(94.21%) patients. There was no signiﬁcant association between wound infection and age and gender. Conclusion: Single dose preoperative antibiotics were found effective in controlling post-operative wound infection without the need of extending the antibiotics to post-operative period in cases of non-perforated appendicitis.Keywords: Non-perforated appendicitis, Wound infection, Prophylactic antibiotics
O’Connell PR, The vermiform appendix. In: Williams NS, Bulstrode CJK, O’Connell PR, editors. Bailey and Love’s short practice of surgery. 26th ed. London, UK: Edward Arnold Ltd, 2013.p.1199-1201.
Mehrabi Bahar M, Jangjoo A, Amouzeshi A, Kavianifar K. Wound infection incidence in patients with simple and gangrenous or perforated appendicitis. Arch Iran Med 2010;13:13–6.
Chamisa I. A clinicopathological review of 324 appendices removed for acute appendicitis in Durban, South Africa: a retrospective analysis. Ann R Coll Surg Engl 2009;91:688–92.
Bickel A, Gurevits M, Vamos R, Ivry S, Eitan A. Perioperative hyperoxygenation and wound site infection following surgery for acute appendicitis: a randomized, prospective, controlled trial. Arch Surg 2011;146:464–70.
Hussain MI, Alam MK, Al-Qahatani HH, Al-Akeely MH. Role of postoperative antibiotics after appendectomy in non-perforated appendicitis. J Coll Physicians Surg Pak 2012;22:756–9.
Fraser JD, Aguayo P, Leys CM, Keckler SJ, Newland JG, Sharp SW, et al. A complete course of intravenous antibiotics vs. a combination of intravenous and oral antibiotics for perforated appendicitis in children: a prospective, randomized trial. Pediatr Surg 2010;45:1198–1202.
Abdullah S, Vaithianathan R, Rajendiran K, Santhanam R. Randomized clinical trial of single versus three doses of cefazolin as prophylaxis for nonperforated acute appendicitis. IJCRR 2012;4:124–30.
Ravari H, Jangjoo A, Motamedifar J, Moazzami K. Oral metronidazole as antibiotic prophylaxis for patients with nonperforated appendicitis. Clin Exp Gastroenterol 2011;4:273–6.
Coakley BA, Sussman ES, Wolfson TS, Bhagavath AS, Choi JJ, Ranasinghe NE, et al. Postoperative antibiotics correlate with worse outcomes after appendectomy for nonperforated appendicitis. J Am Coll Surg. 2011; 213:778–83.
Malik SA, Rasheed M, Abbasi AS, Iqbal RA, Mian MA. Role of signal dose preoperative antibiotic in acute nonperforated appendicitics. Pak Armed Forces Med J 2013;63:114–7.
Davey PG, Nathwani D. What is the value of preventing postoperative infections? New Horiz 1998;6:64–71.
Riou JP, Cohen JR, Johnson H Jr. Factors influencing wound dehiscence. Am J Surg 1992;163:324–30.
Bucknall TE, Cox PJ, Ellis H. Burst abdomen and incisional hernia: a prospective study of 1129 major laparotomies.Br Med J (Clin Res Ed) 1982;284:931–3.
Irvin TT, Stoddard CJ, Greaney MG, Duthie HL. Abdominal wound healing: a prospective clinical study. Br Med J 1977;2:351–2.
Cohn SM, Giannotti G, Ong AW, Varela JE, Shatz DV, McKenney MG, et al. Prospective randomized trial of two wound management strategies for dirty abdominal wounds. Ann Surg. 2001; 233:409–13.
Gupta R, Sample C, Bamehriz F, Birch DW. Infectious complications following laparoscopic appendectomy. Can J Surg. 2006; 49:397-400.
Derek WM, Lillian SK. Controversies in appendicitis. Surgical Infections. 2008; 9:553–8.
Busttil RW, Davidson RK, Fine M, Tompkins RK. Effect of prophylactic antibiotics in acute nonperforated appendicitis. Ann Surg. 1981; 194:502–8.
Bauer T, Vennits B, Holm B, Hahn-Pedersen J, Lysen D, Galatius H et al. Antibiotic prophylaxis in acute nonperforated appendicitis. Ann surg. 1989; 209:307-11.
A Danish multicenter study: cefoxitin versus ampicillin + metronidazole in perforated appendicitis. Br J Surg 1984;71:144–6.
Winslow RE, Dean RE, Harley JW. Acute nonperforating appendicitis efficacy of brief antibiotic prophylaxis. Arch Surg 1983;118:651–5.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.