Abstract
Background and purpose: Appendectomy considered at the top of emergency surgical procedures worldwide, and surgical site infection (SSI) is not an uncommon complication postoperatively. Many factors may be contributed to SSI occurrence; either during preoperative, intraoperative, or postoperative periods. No recent studies focusing on SSI post-appendectomy and the related factors in our region. So, we aim to find the prevalence and detect the factors that may lead to SSI in post-appendectomy patients at King Abdulaziz University Hospital (KAUH) between 2013 and 2017.Methods: This is a retrospective chart review study. Data were collected by data collection sheet from (KAUH) patient’s database, as we include: patients' demographics, blood investigations, operation details, co-morbidities, and hospitalization time. All patients who underwent appendectomy between 2013 and 2017 were included. We used frequencies, Mann-Whitney U test, and binary logistic regression tests for data analysis.Result: SSI post-appendectomy was found in 31 patients out of 433. SSI was statistically significant related more with an open technique of appendectomy (p=0.0001), longer duration of the surgery (p=0.0001), perforated type of appendicitis (p=0.002), more hospitalization time (p=0.0004), postoperative lab results of high WBC count (p=0.004), and low albumin (p=0.011). Other factors including demographics and clinical characteristics, intraoperative, perioperative, and hemoglobin level showed no significant relations.Conclusion: Controlling the high rate of SSI by using the optimal technique of approach, decreasing the duration of the surgery, and early intervention may help more in reducing SSI post-appendectomy. Taking into consideration the other perioperative factors will lead to better outcomes for the patients.
Highlights
Appendectomy is considered very popular and standard management in many cases of acute appendicitis
The incidence of appendicitis or appendectomy according to Ferris et al, in their review of the population-based study was more stable in western countries than in newly industrialized countries where an increasing pattern of incidence was observed [1]
Except for those patients who had colon procedures that include the removal of the appendix, or had a major procedure that is not related to the appendix but appendectomy was done incidentally, they have been excluded from the study because of the higher risk for surgical site infection (SSI)
Summary
Appendectomy is considered very popular and standard management in many cases of acute appendicitis. A large population sample study in Bergamo, Italy, showed that 16,544 patients were presented with acute appendicitis from 1997 to 2013, and 94.7% of them underwent appendectomy procedures [5]. While in the same hospital, laparoscopic appendectomy was done among 100 children between 1999 and 2003 [7] Another previous study at King Abdulaziz University Hospital (KAUH) in 2003 showed 124 females patients presented in the emergency department, where 103 (83.1%) of them underwent appendectomy [8]. Appendectomy considered at the top of emergency surgical procedures worldwide, and surgical site infection (SSI) is not an uncommon complication postoperatively. We aim to find the prevalence and detect the factors that may lead to SSI in post-appendectomy patients at King Abdulaziz University Hospital (KAUH) between 2013 and 2017
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