Ten years Siriraj’s experience of wound infection rate at the third post-operative day or the day of discharge in appendicitis pediatric patients.
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Date
2009-07
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Abstract
Objective: Primary: To find the wound infection rate at the third postoperative day 3 or the day of discharge from Siriraj Hospital, Bangkok, Thailand.
Secondary: To find factors that might cause postoperative wound infection: age, body weight, mean time of the first wound dressing, duration of abdominal pain before operation, pre-diagnosis antibiotic administration, duration of anesthesia and operation, and type of suture material.
Methods: Retrospective reviews of medical records of the division of pediatric surgery diagnosed appendicitis from 1997-2006 were used to form the study group. Data collected included personal profile, abdominal pain before diagnosed appendicitis, medication used before being diagnosed, type and duration of preoperative antibiotics, operative time, time in operating room, length of stay, time of the first dressing after operation, and wound infection were collected. Data were collected to be analyzed for descriptive and analytic method between the wound infection group and the no wound infection group and between the complicated (ruptured or gangrenous) appendicitis and the non complicated (acute or acute suppurative) appendicitis groups.
Results: There were 433 patients. Appendectomy wounds were opened in the third operative day or the day of discharge in 109 patients. Two wound separations, 1 wound infection and 8 wounds that had discharge were found. The average time of first wound dressing after operation was 64.31 hours. Three out of 4 wound infections were diagnosed after discharge from the hospital. The average time in the operating room was longer in the wound infection group compared with the uninfected group (P = 0.042). Patients with complicated appendicitis had more incidence of wound infection than patients with non complicated appendicitis (P = 0.015). Compared between the non complicated and the complicated appendicitis group, the age and bodyweight of the complicated group were lower than the other group (P = 0.009 and 0.05, respectively). Patients with complicated appendicitis had a longer duration of abdominal pain before being diagnosed with appendicitis and a longer length of stay (LOS) (P <0.001).
Conclusion: Wound infection is rarely diagnosed at the third operative day or the day of discharge. Complications from wound dressing, including wound separation and psychological problems, were more common than the wound infection that was detected at that time. Patients with the wound infection spent a longer time in the operating room. The patients with complicated appendicitis were younger and had a lower bodyweight. They had a longer duration of abdominal pain before admission, had a longer length of hospital stay, and had more incidence of wound infection compared with the non complicated group.
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Keywords
Appendicitis, postoperative complications, wound infection, wound dressing
Citation
Mungnirandr Akkrapol, Thoamphoemphol Anchana, Supasynth Piyaporn. Ten years Siriraj’s experience of wound infection rate at the third post-operative day or the day of discharge in appendicitis pediatric patients. Siriraj Medical Journal, 2009 Jul; 61(4): 197-199.