Post-appendectomy Infected Wounds and Ideal Management A Retrospective Study

Abstract

Background :Abdominal operations are traditionally classified into elective and emergency procedures both of which may be complicated by postoperative wound infections. Although postoperative wound infection is usually infrequent following elective procedures, it is an anticipated and acceptable complication of emergency surgeries as these operations are usually of a contaminated nature with no standard preoperative preparation associated with an urge to operate.
Objectives :This study tries to compare the results of a two adopted regimes to manage post-appendectomy wound infections in regard to the significance of using parenteral antibiotics. Methods : This study had evaluated (108) patients with clinical postoperatively wound infections over a period of (3) years in Al-Hilla General Teaching Hospital. All cases with normal appendices and those on preoperative antibiotics therapy for any reason had been excluded from the study. Two treatment regimes had been evaluated : Regime (A) consisting of changing antiseptic wound dressings only while Regime (B) consisted of changing antiseptic wound dressings combined with parenteral administration of intravenous metronidazole (500) mg thrice daily with intravenous cefotaxime (1000) mg twice daily. The study group had been allocated to a randomized single-blind trial to assess the outcomes. Patients were followed– up to an average of (50) days.
Results :There is a beneficial effects of adopting Regime (B) in the management of infected wounds following perforated appendectomies in terms of reducing the number of dressings change and the period of inpatients hospitalization . This was not the case with infected wounds following nonperforated
appendectomies.
Conclusion : According to the literature reviewed, in order to prevent or reduce the rate of post-appendectomy infected wounds it is recommended to use preoperative prophylactic antibiotics which is not a routine in our practice.Wound irrigation with antiseptics may be beneficial in prevention of wound infection following complicated appendectomy. Regime (B) of treatment should be reserved for infected wounds following complicated appendectomy.