Keywords : appendesectomy
REDUCTION OF POSTOPERATIVE WOUND INFECTION AFTER APPENDECTOMY BY PERITONEAL CLOSURE AND WOUND IRRIGATION WITH NORMAL SALINE
Basrah Journal of Surgery,
2012, Volume 18, Issue 2, Pages 26-31
The most common complication following appendectomy is postoperative wound infection and
since it has major effects on patient’s health & recovery and on the health system as it
consumes time and essential resources so from this fact came the importance of the researches
that are done to find any means to reduce postoperative wound infection and many of them
have been shown to be beneficial in reducing wound infection like the use of prophylactic
antibiotics, postoperative antibiotics and laparoscopic appendectomy but in this study we look
for the effectiveness of 2 simple measures which are peritoneal closure and wound irrigation
with normal saline in reducing the incidence of postoperative wound infection. Aim of the study:
to know if peritoneal closure and wound irrigation with normal saline would significantly reduce
the incidence of postoperative wound infection after appendectomy.
The study had been carried out from January 2010 to January 2012 in Al-Mawanee General
Hospital and it had been done by the same surgeon and as emergency cases.
The study included 297 patients divided into: The control group: include those in whom no
peritoneal closure and no wound irrigation were done, patients in this group were 153.
Case group: include those in whom peritoneal closure and wound irrigation with normal saline
had been done and it included 144 patients. Comparison between the two groups had been
done according to sex, age, and the state of inflammation of the appendix also factors affecting
wound healing and increasing the incidence of wound infection had been taken in consideration.
Data were analyzed using P value to determine the significance of the results.
Although the incidence of acute appendicitis was slightly higher in males but the incidence of
wound infection was found to be higher in females but it was not statistically different so sex is
not a risk factor for the development of wound infection in both groups. Regarding age, in both
control and case groups, the highest rate of incidence of acute appendicitis was in the age
group 21-40 years but the highest rate of wound infection was in the age group 60 years and
above, it was 50% in control group and 16% in the case group and so age is a risk factor for the
development of wound infection and there is a clear reduction in the incidence of wound
infection after the use of peritoneal closure and wound irrigation with normal saline and there
were also reduction in the incidence of wound infection in all other age groups after using these
two measures. Regarding the state of severity of inflammation of the appendix the highest rate
of wound infection was found in the severe appendicitis subgroup in both the control (infection
rate was 31.4%) and case (9.6%) groups but again there was a clear reduction in the incidence
of wound infection.
In conclusion: peritoneal closure and wound irrigation with normal saline help in reducing the
incidence of postoperative wound infection after appendectomy.