Association of Wound Infection with Various Surgical Technique Applied for Appendectomy in Diabetic and Hypertensive Patients

2021 ◽  
Vol 15 (8) ◽  
pp. 2163-2165
Author(s):  
Muhammad Armughan ◽  
Imran Sadiq ◽  
Shafqat Mukhtar ◽  
Hafiz Ahmad Altaf
Keyword(s):  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Surgical Procedure ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
Diabetic Patients ◽  
Wound Infections ◽  
Hypertensive Patients ◽  
Duration Of Surgery ◽  
Perforated Appendix

Background: Perforated appendix in diabetic as well as hypertensive patients is associated with elevated risks of postoperative infectious complications such as wound infection and intra-abdominal abscess. Objective: To identify better appendectomy procedure for diabetic and hypertensive patients. Study Design: Randomized Controlled Trial Place and Duration of Study: Department of Surgery, Unit l, Bahawal Victoria Hospital Bahawalpur from 10th October 2020 to 9th April 2021. Methodology: Ninety eight patients meeting the criteria of perforated appendix were divided in two groups; one group consisted of 49 patients who were managed by open surgical procedure. Second group was consisted of 49 patients who were managed by laparoscopic surgical procedure. Patient outcomes in-terms of wound infections, operative time and duration of surgery was assessed. Results: Mean age of patients was 25.49±6.03 years. There were 17 hypertensive while 15 diabetic patients. Wound infection was seen in 21% and 28% open surgery diabetic and hypertensive patients respectively in comparison to 10%and 8% in laparoscopic appendectomy diabetic and hypertensive patients respectively (p<0.001). Conclusion: Laparoscopic appendectomy (LA) is associated with significantly lower rates of post-operative wound infections and shorter hospital stay in comparison to open appendectomy in diabetic and hypertensive patients of perforated appendicitis. Key Words: Perforated appendix, laparoscopic, open appendectomy

scholarly journals Study of laparoscopic appendectomy: advantages, disadvantages and reasons for conversion of laparoscopic to open appendectomy

2017 ◽  
Vol 4 (3) ◽  
pp. 993
Author(s):  
Sujan Narayan Agrawal ◽  
Sunita Meshram ◽  
Kamlesh Dhruv
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Normal Activity ◽  
Organ Injury ◽  
Cross Sectional ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery

Background:Good outcome has been reported with the laparoscopic approach in uncomplicated appendicitis, but a higher incidence of postoperative intraabdominal abscesses has been reported after laparoscopic appendectomy in complicated appendicitis. Objective was to study the efficacy of laparoscopic appendectomy.Methods: A Hospital based cross sectional study was carried out among of 302 patients. The study duration was from June 2004 to December 2006. Institutional Ethics Committee permission was obtained. Informed individual consent was taken. Out of 302 subjects, 236 underwent open appendectomy and 66 underwent laparoscopic appendectomy.Results:It was observed that in both the groups majority patients had retrocecal position of the appendix. The amount of blood loss, adjacent organ injury and duration of surgery were similar in both the groups. The difference in the incidence of wound infection in both groups was not found to be statistically significant. But the antibiotic use was significantly less in the LA group compared to OA group. It was found that time to resumptions of oral fees, duration of hospital stay and time to return to normal duties were significantly lesser in LA group compared to OA group. (p < 0.001). As per the cosmetic end result, majorities were satisfied in LA group and rated the surgery as excellent as compared to patients in OA group.Conclusions:Laparoscopic appendectomy was better than open appendectomy with respect to wound infection, tackling co-existing pathology, duration of hospital stay, earlier return to normal activity, excellent cosmetic end result, lesser use of antibiotics and earlier resumption of oral feeds.

scholarly journals Comparison of laparoscopic appendectomy versus open appendectomy in acute appendicitis in obese diabetic patients

2020 ◽  
Vol 10 (3) ◽  
pp. 145-148
Author(s):  
Mohammuddunnobi ◽  
Tasnuva Jahan ◽  
Abdullah Al Amin
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Operating Time ◽  
Open Appendectomy ◽  
World Health ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Post Operation

Background: Acute appendicitis (AC) is a common surgical problem requiring emergency hospitalization for urgent appendectomy. In case of diabetic patients, the incidence of developing acute appendicitis including its complications like abscess, gangrene and perforation is higher than non-diabetic. Day by day, laparoscopic appendectomy is having an improved outcome in non-diabetic and non-obese patients. The aim of this study was to compare the outcomes of laparoscopic appendectomy versus open appendectomy in acute appendicitis of obese diabetic patients. Methods: A comparative study was carried out in a tertiary care hospital in Dhaka City. Hospitalized obese diabetic patients with a diagnosis of acute appendicitis, who underwent appendectomy, were considered as study population. Obesity was defined as body mass index (BMI) greater than 30 kg/m2 according to World Health Organization and American Obesity Association guidelines. Patients were divided into two groups according to type of appendectomy; 50 patients by laparoscopic appendectomy as group LA and 50 patients by open appendectomy as group OA. Results: Most patients were obese I (30.0-34.9 kg/m2) in group LA and OA (92.0% and 86.0%, respectively, p<0.05). Uncontrolled diabetes mellitus was detected in most of the patients of both group LA (96.0%) and OA (98.0%). Mean operation time, mean duration of post-operation ileus, mean hospital stay and post-operation complications were less in group LA than group OA which is statistically significant (p< 0.05). No patient developed wound infection after laparoscopic appendectomy; whereas, 8.0% patients had wound infection in open appendectomy (p<0.05). Conclusion: In this study, laparoscopic appendectomy had good outcome over its open counterpart regarding shorter operating time, hospital stay, less wound infection, postoperative pain and time to return to usual activities. Birdem Med J 2020; 10(3): 145-148

scholarly journals Management of wound infection after appendectomy: are parenteral antibiotics useful?

2021 ◽  
Vol 8 (4-5) ◽  
pp. 638-644
Author(s):  
B. Harahsheh ◽  
B. Hiyasat ◽  
A. Abulail ◽  
M. Al Basheer
Keyword(s):  
Povidone Iodine ◽  
Perforated Appendicitis ◽  
Length Of Hospital Stay ◽  
District General Hospital ◽  
Antibiotic Use ◽  
Wound Infections ◽  
Perforated Appendix ◽  
The Mean ◽  
To Receive ◽  
Single Blind

This study investigated the use of antibiotics in the treatment of wound infections after appendectomy. The subjects were 72 patients with post-operative wound infections at a district general hospital in Jordan. All patients received daily antiseptic dressings with povidone-iodine 10% in alcohol. The patients were randomized in a single-blind trial to receive either no antibiotics or parenteral antibiotics metronidazole and cefoxitin. There was no significant effect of antibiotic use in patients with early inflamed or severely inflamed appendicitis. However, for patients with perforated appendicitis the mean length of hospital stay and the mean frequency of change of dressings were significantly reduced. We conclude that antibiotics do not offer any advantage in post-appendectomy wound infections except for cases of perforated appendix

Advantages of Laparoscopic Appendectomy in the Elderly

2006 ◽  
Vol 72 (6) ◽  
pp. 474-480 ◽  
Author(s):  
Andrew G. Harrell ◽  
Amy E. Lincourt ◽  
Yuri W. Novitsky ◽  
Michael J. Rosen ◽  
Timothy S. Kuwada ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
Laparoscopic Approach ◽  
The Elderly ◽  
Adult Patients ◽  
Perioperative Outcomes ◽  
Skilled Nursing ◽  
Total Charges

Laparoscopic appendectomy (LA) has gained in popularity in recent years. The number of elderly patients undergoing appendectomy has increased as that segment of the population has increased in number; however, the utility and benefits of LA in the elderly population are not well established. We hypothesized that LA in the elderly has distinctive advantages in perioperative outcomes over open appendectomy (OA). We queried the 1997 to 2003 North Carolina Hospital Association Patient Data System for all patients with the primary ICD-9 procedure code for OA and LA. Patients ≥65 years of age (elderly) were identified and reviewed. Outcomes including length of stay (LOS), charges, complications, discharge location, and mortality were compared between the groups. There were 29,244 appendectomies performed in adult patients (>18 years old) with 2,722 of these in the elderly. The annual percentage of LA performed in the elderly increased from 1997 to 2003 (11.9–26.9%, P < 0.0001). When compared with OA, elderly patients undergoing LA had a shorter LOS (4.6 vs 7.3 days, P = 0.0001), a higher rate of discharge to home (91.4 vs 78.9%, P = 0.0001) as opposed to a step-down facility, fewer complications (13.0 vs 22.4%, P = 0.0001), and a lower mortality rate (0.4 vs 2.1%, P = 0.007). When LA was compared with OA in elderly patients with perforated appendicitis, LA resulted in a shorter LOS (6.8 vs 9.0 days, P = 0.0001), a higher rate of discharge to home (86.6 vs 70.9%, P = 0.0001), but equivalent total charges ($22,334 vs $23,855, P = 0.93) and mortality (1.0 vs 2.98%, P = 0.10). When elderly patients that underwent LA were compared with adult patients (18–64 years old), they had higher total charges ($16,670 vs $11,160, P = 0.0001) but equivalent mortality (0.37 vs 0.15%, P = 0.20). The use of laparoscopy in the elderly has significantly increased in recent years. In general, the safety and efficacy of LA is demonstrated by a reduction in mortality, complications, and LOS when compared with OA. The laparoscopic approach to the perforated appendix in the elderly patient has advantages over OA in terms of decreased LOS and a higher rate of discharge to home as opposed to rehabilitation centers, nursing homes, or skilled nursing care. When compared with all younger adults, the laparoscopic approach in the elderly was associated with equal mortality rates even though hospitalization charges were higher. Laparoscopy may be the preferred approach in elderly patients who require appendectomy.

scholarly journals Laparoscopic Appendectomy Trends and Outcomes in the United States: Data from the Nationwide Inpatient Sample (NIS), 2004–2011

2014 ◽  
Vol 80 (10) ◽  
pp. 1074-1077 ◽  
Author(s):  
Hossein Masoomi ◽  
Ninh T. Nguyen ◽  
Matthew O. Dolich ◽  
Steven Mills ◽  
Joseph C. Carmichael ◽  
...  
Keyword(s):  
United States ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Conversion Rate ◽  
Nationwide Inpatient Sample ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
The United States ◽  
Hospital Charges ◽  
Nationwide Inpatient Sample Database

Laparoscopic appendectomy (LA) is becoming the standard procedure of choice for appendicitis. We aimed to evaluate the frequency and trends of LA for acute appendicitis in the United States and to compare outcomes of LA with open appendectomy (OA). Using the Nationwide Inpatient Sample database, we examined patients who underwent appendectomy for acute appendicitis from 2004 to 2011. A total of 2,593,786 patients underwent appendectomy during this period. Overall, the rate of LA was 60.5 per cent (children: 58.1%; adults: 63%; elderly: 48.7%). LA rate significantly increased from 43.3 per cent in 2004 to 75 per cent in 2011. LA use increased 66 per cent in nonperforated appendicitis versus 100 per cent increase in LA use for perforated appendicitis. The LA rate increased in all age groups. The increased LA use was more significant in male patients (84%) compared with female patients (62%). The overall conversion rate of LA to OA was 6.3 per cent. Compared with OA, LA had a significantly lower complication rate, a lower mortality rate, a shorter mean hospital stay, and lower mean total hospital charges in both nonperforated and perforated appendices. LA has become an established procedure for appendectomy in nonperforated and perforated appendicitis in all rates exceeding OA. Conversion rate is relatively low (6.3%).

Laparoscopic appendectomy for perforated appendicitis: a comparison with open appendectomy

2006 ◽  
Vol 20 (7) ◽  
pp. 1051-1054 ◽  
Author(s):  
A. Yagmurlu ◽  
A. Vernon ◽  
D. C. Barnhart ◽  
K. E. Georgeson ◽  
C. M. Harmon
Keyword(s):  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Perforated Appendicitis

scholarly journals Appendectomized Patient and Infections after Surgery

2016 ◽  
Vol 9 (1) ◽  
pp. 46
Author(s):  
Mohammad Reza Asgary ◽  
Hosein Hemmati
Keyword(s):  
Postoperative Complications ◽  
Abdominal Surgery ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Google Scholar ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The World ◽  
Perforated Appendix ◽  
The Common

Appendicitis is one of the common surgeries all over the world, and its diagnosis is difficult and based on clinical examinations or its symptoms. Moreover, after the surgery is accomplished, it is probable that the patient is faced with certain problems and complications. In this regard, the present study was carried out in order to review the infections caused after appendicitis surgery. The databases like PubMed, Google Scholar, and Science Direct and relevant articles were collected, in which keywords like appendicitis surgery, perforation, laparoscopy, and infection had been used. A total number of 6,000 articles were retrieved, out of which, 74 relevant articles were examined. The results of the present study indicated that perforated appendix can be the biggest cause of infection and abscess after intra-abdominal surgery. An increase in the level of C-reactive protein and leukocytes is accompanied with the risk of postoperative complications including infection and abscess. Numerous studies have reported that formation of infection and abscess after laparoscopic appendectomy is a little more than open appendectomy. It is not necessary to consume antibiotics after a non-perforated appendectomy. It is sufficient to consume antibiotics for 3 to 5 days after a perforated appendectomy to prevent infection and abscess. With the above results now it is evident that the appendicitis and its complications are still a common problem among people all over the world. There is still much to discuss among the surgeons with regards to appendicitis and its complications.

scholarly journals Appendectomized Patient and Infections after Surgery

2016 ◽  
Vol 9 (1) ◽  
pp. 46
Author(s):  
Mohammad Reza Asgary ◽  
Hosein Hemmati
Keyword(s):  
Postoperative Complications ◽  
Abdominal Surgery ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Google Scholar ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
The World ◽  
Perforated Appendix ◽  
The Common

Appendicitis is one of the common surgeries all over the world, and its diagnosis is difficult and based on clinical examinations or its symptoms. Moreover, after the surgery is accomplished, it is probable that the patient is faced with certain problems and complications. In this regard, the present study was carried out in order to review the infections caused after appendicitis surgery. The databases like PubMed, Google Scholar, and Science Direct and relevant articles were collected, in which keywords like appendicitis surgery, perforation, laparoscopy, and infection had been used. A total number of 6,000 articles were retrieved, out of which, 74 relevant articles were examined. The results of the present study indicated that perforated appendix can be the biggest cause of infection and abscess after intra-abdominal surgery. An increase in the level of C-reactive protein and leukocytes is accompanied with the risk of postoperative complications including infection and abscess. Numerous studies have reported that formation of infection and abscess after laparoscopic appendectomy is a little more than open appendectomy. It is not necessary to consume antibiotics after a non-perforated appendectomy. It is sufficient to consume antibiotics for 3 to 5 days after a perforated appendectomy to prevent infection and abscess. With the above results now it is evident that the appendicitis and its complications are still a common problem among people all over the world. There is still much to discuss among the surgeons with regards to appendicitis and its complications.

scholarly journals Laparoscopic Versus Open Appendicectomy: A Comparison of Primary Outcome

2015 ◽  
Vol 9 (2) ◽  
pp. 84-87
Author(s):  
Md Mazedur Rahman ◽  
Md Siddiqur Rahman ◽  
Guljar Ahmed ◽  
Md Mushfiqur Rahman ◽  
Md Zohirul Islam Miah ◽  
...  
Keyword(s):  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Early Discharge ◽  
Early Return ◽  
The Mean ◽  
Group 2 ◽  
A Prospective Study ◽  
Duration Of Operation ◽  
Laparoscopic Versus Open Appendectomy

Currently, laparoscopic appendectomy is widely practiced for the management of acute appendicitis. It is not clear whether open or laparoscopic appendectomy is more appropriate. Our aim was to compare the safety and the advantages of laparoscopic versus open appendectomy in a prospective study. 102 patients were participated in this study. The group 1 patients were subjected to laparoscopic appendectomy [LA], whereas the group 2 patients were subjected to open appendectomy [OA]. 46 patients included in LA group and 54 patients in OA group. The mean operative time for LA and OA was 84.4 (45-220) minutes and 59 (30-180) minutes respectively. Although LA was associated with a shorter hospital stay [LA-3.5 days versus OA-5 days] but duration of operation is prolong in LA than OA and the postoperative wound infection is significantly higher in OA than LA. LA is safe and superior to OA in respect to an early discharge, lesser postoperative pain; decreased post operative wound infection, early return to work and a better cosmetic scar.Faridpur Med. Coll. J. 2014;9(2): 84-87

COMPARISION OF SURGICAL SITE INFECTION BETWEEN OPEN APPENDECTOMY AND LAPAROSCOPIC APPENDECTOMY

2021 ◽  
pp. 25-25
Author(s):  
J. Sudhakar ◽  
Manoj Karthik Gera
Keyword(s):  
Surgical Site Infection ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Length Of Hospital Stay ◽  
Site Infection ◽  
Operative Complications ◽  
Bowel Movements ◽  
Perforated Appendix ◽  
Health Care Associated Infection

Appendectomy is most common surgical procedure in emergency surgery. Inamed appendix can be removed laparoscopically (laparoscopic appendectomy) or openly (open appendectomy). Surgical site infection is representative of health care associated infection in which it may effect on patients' morbidity and mortality. The aim of the study is to compare laparoscopic appendectomy and open appendectomy in terms of surgical site infection. The frequency of 60 patients who underwent appendectomy open appendectomy-40;laparoscopic appendectomy-20 between September 2019- march2020 which were retrospectively reviewed for demographic and pathological characteristic, recovery of bowel movements, length of hospital stay and post-operative complications. The frequency of purulent/gangrenous or perforated appendix were Laparoscopic appendectomy-10% and in open appendectomy 20%. The time of rst atus after surgery were 2.9 days and in open appendectomy were 2.97 days in laparoscopic appendectomy. Length of hospital stay were relatively short in laparoscopic appendectomy group and in open appendectomy group The frequency of overall surgical site infection were not that difference between the two groups laparoscopic appendectomy -15% open appendectomy group were22%But that of supercial surgical site infection was signicantly lower in laparoscopic appendectomy group5% open appendectomy group 15%.

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