Abstract
Wound infections following appendectomy continue to occur at a surprisingly high rate. Individual prophylactic methods have been shown to reduce the incidence but are unlikely to eliminate infections owing to the multifactorial nature of their etiology. No study in which multiple methods were used has yet been reported. In this study 100 consecutive cases of appendicitis were treated by multiple methods including good surgical technique, protective wound packs, avoidance of drains, and systemic antibiotics (penicillin, gentamicin, and clindamycin), in appendicitis associated with perforation, gangrene, or abscess formation. By using these methods a 1% wound infection rate was achieved, the lowest rate yet reported for 100 consecutive cases of appendicitis.
Résumé
L'infection pariétale secondaire à l'appendicectomie atteint encore un taux surprenant. Des méthodes prophylactiques particulières ont été prises pour le réduire mais elles ne permirent pas d'atteindre ce but en raison des multiples causes qui sont à l'origine de l'infection. Aucune étude comportant l'association de multiples moyens de prévention n'a été rapportée. L'auteur s'est donc livré à l'étude de 100 cas d'appendicite traités consécutivement en employant des moyens multiples: bonne technique chirurgicale, protection de l'incision pariétale, proscription du drainage, antibiothérapie générale (pénicilline, gentamycine, et clindamycine) pour traiter des appendicites graves: perforation, gangrène, abcès appendiculaires.
En observant ces règles, le taux de l'infection n'a pas dépassé un pour cent.
Resumen
Las infecciones de herida después de apendectomía continúan ocurriendo con una incidencia sorprendentemente elevada. Métodos profilácticos individuales han demostrado capacidad para reducir tal incidencia, pero posiblemente no serán capaces de eliminar totalmente la infección debido a la naturaleza multifactorial de su etiología.
Hasta ahora no se ha informado estudio alguno en el cual se hayan utilizado métodos múltiples.
En el presente estudio 100 casos consecutivos de apendicitis fueron tratados con métodos múltiples incluyendo: técnica quirúrgica meticulosa, proteccion de la herida con compresas, eliminación del uso de drenes y antibióticos sistémicos (penicilina, gentamicina y clindamicina) en los casos de apendicitis asociada con perforación, gangrena o absceso. Mediante el uso de estos métodos se logró una incidencia de infección de herida del 1%, la más baja que se haya informado hasta la fecha en una serie de 100 casos consecutivos de apendicitis.
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Gaffney, P.R. Wound infections in appendicitis: Effective prophylaxis. World J. Surg. 8, 287–291 (1984). https://doi.org/10.1007/BF01655054
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DOI: https://doi.org/10.1007/BF01655054