J Korean Surg Soc.  2003 Nov;65(5):425-430.

Peritoneal Saline Irrigation and Infective Complications in Perforated Appendicitisin at a Single Center

• Lee W
• Lee J
• Lee B

Abstract

PURPOSE
Until recently, the surgical treatment of perforated appendicitis in South Korea showed a relatively high incidence of postoperative infectious complications compared with centers having protocols for managements. Authors have been performing appendectomies for perforated cases under the principle of massive irrigation of the peritoneal cavity and primary closure of incision wound that leaves a suction drain from pelvic cavity, expecting reducing chance of infective complications and thus reducing the stress faced by operators. METHODS: Among 788 cases of appendicitis from September 1997 to December 2002, 172 patients showing perforation and peritonitis in the operative field were reviewed retrospectively. All the operations were performed by the principle mentioned above, and data were collected on various major complications, especially infective wound and intra-abdominal complications. RESULTS: There were 7 cases of suppurative wound infection, and 5 cases of intra-abdominal abscess, representing a total incidence of 7.0% (n=12) in 172 patients. Other major complications such as adhesive ileus (n=3), intestinal fistula (n=1), or remote organ infective event (n=1) were also recognized. CONCLUSION: Massive saline irrigation during appendectomy of perforated appendicitis-without antibiotic mixture-that leaves a negative suction drain from the pelvic cavity and the primary closure of incision wounds have yielded satisfactory results concerning various aspects, especially in lessening infective postoperative complications.

Keyword

Perforated appendicitis; Wound infection; Intra-abdominal abscess; Irrigation; Primary closure

MeSH Terms

Abdominal Abscess
Adhesives
Appendectomy
Appendicitis
Humans
Ileus
Incidence
Intestinal Fistula
Korea
Peritoneal Cavity
Peritonitis
Postoperative Complications
Retrospective Studies
Suction
Wound Infection
Wounds and Injuries
Adhesives