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2002, Number 5

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Cir Cir 2002; 70 (5)

Primary vs delayed closure in complicated apendicitis

Morales-Guzmán MI, Navarrete-Alemán JE

Language: Spanish
References: 24
Page: 329-334
PDF size: 55.33 Kb.


ABSTRACT

Introduction: The diagnosis of appendicitis is difficult to date because of medications at the beginning of the clinical course, in addition to other causes. When perforated appendicitis is present, surgeons need to decide on the best treatment for the surgical wound to obtain patient recuperation as soon as possible. Objective: Our objective was to determine whether surgical wound infection due to complicated appendicitis is lesser in patients undergoing primary closure than in those with delayed closure. Material and methods: A prospective and comparative study was made. A total of 30 patient of both genders with a diagnosis of acute perforated appendicitis were studied; they were distributed into two groups of 15 patients, each. Group II patients were managed with delayed closure of surgical wound. Infection of surgical wound, premedications, complications, hospital stay, and leukocyte count were assessed. Statistical analysis was done with chi square, Fisher exact test, and Student t. Results: Wound infection did not have a significant result in both groups; in group I, 6% of patients presented infection of the surgical wound and in group II, 20% (p › 0.05). In group I, hospital-stay was significantly less than in group II (p ‹ 0.05). In this study, primary closure of the skin after appendectomy for perforated appendicitis was not associated with increased infection risk of skin compared to delayed closure.


REFERENCES

  1. Martínez de JF, Gallardo HR, Morales GM, Pérez MA. Retardo en la hospitalización, el diagnóstico y la intervención quirúrgica de la apendicitis aguda. Rev Gastroenterol Mex 1995;60:17-21.

  2. Schwartz SI. Appendix. In: Schwartz SI, editor. Principles of surgery. 6th ed. New York: McGraw-Hill, Inc.;1994.Pp.1347-1358.

  3. Rucinski J, Fabian T, Panagopoulos G. Gangrenous and perforated appendicitis: a meta-analytic study of 2,532 patients. Surgery 2000;127:136-141.

  4. Paidss CN. Acute appendicitis. In: Cameron JL, editor. Current surgical therapy. 5th ed. St. Louis, MO, USA: Mosby;1995.Pp.213-261.

  5. Liu CD, McFadden DW. Acute abdomen and appendix. In: Greenfield LJ, editor. Surgery: scientific principles and practice. 3rd ed. Philadelphia, PA, USA: JB Lippincott;1997.Pp.1246-1261.

  6. Berne I, Ortega A. Appendicitis and appendiceal abscess (editor’s comments). In: Nyhus LM, Baker RJ, Fischer JE, editors. Mastery of surgery. 2nd ed. Little, Brown, and Co.; 1997.Pp.1407-1411.

  7. Rotstein O. Peritonitis y abscesos intraabdominales. Sci Am Surg 1997;9:1-20.

  8. Pettigrew RA. Delayed primary wound closure in gangrenous and perforated appendicitis. Br J Surg 1981;68:635-638.

  9. Styrud J, Erjksson S, Granstrom L. Treatment of perforated appendicitis. Dig Surg 1998;15:683-686.

  10. Cervantes S. Irrigación a presión de la herida quirúrgica en apendicitis complicada. Rev Med Hosp Gen Mex 1996;59:54-58.

  11. Lemier TPI, Rodríguez JL, Jacobs J. Wound management in perforated appendicitis. Am Surg 1999 May;65:439-443.

  12. Ortega LLH, Vargas DA, Miranda FP. Complicaciones locales de la apendicitis. Rev Gastroenterol Mex 1994;59:223-226.

  13. Polous I, Piatnochka V. Determination of the intensity of the warm flow in surgical wound tissue for the evaluation of the severity of inflammatory process. Klin-Khir 1994;8:48-50.

  14. Moskalenko VJ, Zincovich I, Spakhj O. Prognosis in the course of postoperative period in acute appendicitis in children. Khirurgiia-Mosk 1994:32-34.

  15. Lund D, Murphy E. Management of perforated appendicitis in children: a decade of aggressive treatment. J Pediatr Surg 1994;29:1130-1134.

  16. Schmitt P, Hiyama D, Swisher S. Analysis of risk factors of post appendectomy intra-abdominal abscess. J Am Coll Surg 1994;179:721-726.

  17. Evbuomwan I, Onwanyin O. Management of peritonitis in perforated appendicitis in children. East A Med J 1994;71:279-281.

  18. Thompson J Jr, Bennion R, Schmitt P. Cecectomy for complicated appendicitis. J Am Coll Surg 1994;179:135-138.

  19. Gorenstein A, Gewurta GJ, Serour F. Post appendectomy intra-abdominal abscess: The therapeutic approach. Arch Dis Child 1994;70: 400-402.

  20. Berends FI, Vermeulen M, Leguit P. Perforation rate and diagnostic accuracy in acute appendicitis. Med Tijdschr Geneeskd 1994;138:350-354.

  21. Guidry S, Poqle G. The anatomy of appendicitis. Am Surg 1994;60:68-71.

  22. Kokoska EJ, SíJen M, Tracy T. Perforated appendicitis in children: risk factors for development of complications. Surgery 1998;124:619-625.

  23. Zarba M, Mazzocchi PJ, Lepiane P. The role of surgery in the treatment of appendicular abscesses. Mínerva Chír 1997;52:577-581.

  24. Reid R, Dobbs BJ, Frizelle F. Risk factors for post appendectomy intra-abdominal abscess. Aus Newz J Surg 1999;69:373-374.




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