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REDUCTION OF POSTOPERATIVE WOUND INFECTION AFTER APPENDECTOMY BY PERITONEAL CLOSURE AND WOUND IRRIGATION WITH NORMAL SALINE

Authors: Ahmad Jaleel Abdul-Razzak --- Zeki A Al-Faddagh
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 Year: 2012 Volume: 18 Issue: 2 Pages: 26-31
Publisher: Basrah University جامعة البصرة

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Abstract

The most common complication following appendectomy is postoperative wound infection andsince it has major effects on patient’s health & recovery and on the health system as itconsumes time and essential resources so from this fact came the importance of the researchesthat are done to find any means to reduce postoperative wound infection and many of themhave been shown to be beneficial in reducing wound infection like the use of prophylacticantibiotics, postoperative antibiotics and laparoscopic appendectomy but in this study we lookfor the effectiveness of 2 simple measures which are peritoneal closure and wound irrigationwith 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 reducethe incidence of postoperative wound infection after appendectomy.The study had been carried out from January 2010 to January 2012 in Al-Mawanee GeneralHospital 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 noperitoneal 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 salinehad been done and it included 144 patients. Comparison between the two groups had beendone according to sex, age, and the state of inflammation of the appendix also factors affectingwound 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 ofwound infection was found to be higher in females but it was not statistically different so sex isnot a risk factor for the development of wound infection in both groups. Regarding age, in bothcontrol and case groups, the highest rate of incidence of acute appendicitis was in the agegroup 21-40 years but the highest rate of wound infection was in the age group 60 years andabove, it was 50% in control group and 16% in the case group and so age is a risk factor for thedevelopment of wound infection and there is a clear reduction in the incidence of woundinfection after the use of peritoneal closure and wound irrigation with normal saline and therewere also reduction in the incidence of wound infection in all other age groups after using thesetwo measures. Regarding the state of severity of inflammation of the appendix the highest rateof wound infection was found in the severe appendicitis subgroup in both the control (infectionrate was 31.4%) and case (9.6%) groups but again there was a clear reduction in the incidenceof wound infection.In conclusion: peritoneal closure and wound irrigation with normal saline help in reducing theincidence of postoperative wound infection after appendectomy.

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