Background: Surgical site infections (SSI) are seen in up to 5% of patients after appendectomy for acute appendicitis. SSI are associated with prolonged hospital stay and increased costs. The aim of this multicenter study was to identify factors associated with SSI after appendectomy for acute appendicitis.
Methods: Patients who underwent appendectomy for acute appendicitis between June 2014 and January 2015 in 6 teaching hospitals in the southwest of the Netherlands were included. Patient, diagnostic, intra-operative and disease-related factors were collected from the patients' charts. Primary outcome was surgical site infection. Multivariable logistic regression was performed to identify independent risk factors for SSI.
Results: Some 637 patients were included. Forty-two patients developed a SSI. In univariable analysis body temperature >38°C, CRP>65 and complex appendicitis were associated with SSI. After multivariable logistic regression with stepwise backwards elimination, complex appendicitis was significantly associated with SSI (OR 4.09; 95% CI 2.04-8.20). Appendiceal stump closure with a stapler device was inversely correlated with SSI (OR 0.40; 95% CI 0.24-0.97) Conclusions: Complex appendicitis is a risk factor for SSI and warrants close monitoring postoperatively. The use of a stapler device for appendiceal stump closure is associated with a reduced risk of SSI.
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http://dx.doi.org/10.1159/000447647 | DOI Listing |
AME Case Rep
November 2024
Department of Orthopaedic Surgery, Sugita Genpaku Memorial Obama Municipal Hospital, Fukui, Japan.
Background: Open pelvic fractures are rare but represent a serious clinical problem with high mortality rates. Acute mortality is often associated with hemorrhage, whereas delayed mortality is most often associated with sepsis and multiple organ failure. We report a case of Wang's classification of type II open pelvic ring fracture with hemorrhagic shock and septic shock from gas gangrene.
View Article and Find Full Text PDFJ Pediatr Surg
January 2025
Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates; Mediclinic Parkview Hospital, Dubai, United Arab Emirates.
Introduction: Up to one-third of pediatric patients with acute appendicitis present with radiological evidence of appendicoliths. However, whether appendicolith presence influences prognosis under conservative management compared to non-appendicolith appendicitis remains uncertain.
Methods: We systematically searched PubMed, Cochrane, Embase, and Web of Science databases for studies comparing pediatric appendicolith and non-appendicolith appendicitis managed conservatively with antibiotics, fluids, and percutaneous drainage.
Eur J Trauma Emerg Surg
January 2025
Centre for Perioperative Optimization, Department of Surgery, Herlev and Gentofte Hospital, University of Copenhagen, Borgmester Ib Juuls Vej 1, Herlev, DK-2730, Denmark.
Purpose: Guidelines for management and treatment of appendicitis recommends the removal of a normal-looking appendix, but the recommendations are deemed as weak because they are based on low quality evidence. We aimed to provide an overview of the recommendations from the European societies or associations of surgeons regarding the treatment of acute appendicitis and especially recommendations for the macroscopically normal-looking appendix.
Methods: European surgical societies were contacted and sent an electronic questionnaire.
J Pediatr Surg
January 2025
McGill University Faculty of Medicine and Health Sciences, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Qc, Canada.
Purpose: This study evaluates the effectiveness of machine learning (ML) algorithms for improving the preoperative diagnosis of acute appendicitis in children, focusing on the accurate prediction of the severity of disease.
Methods: An anonymized clinical and operative dataset was retrieved from the medical records of children undergoing emergency appendectomy between 2014 and 2021. We developed an ML pipeline that pre-processed the dataset and developed algorithms to predict 5 appendicitis grades (1 - non-perforated, 2 - localized perforation, 3 - abscess, 4 - generalized peritonitis, and 5 - generalized peritonitis with abscess).
Objectives: Laparoscopic surgery is widely performed for acute appendicitis. We started conventional 3-port laparoscopic appendectomy (CLA) in 1995 and introduced single-incision laparoscopic appendectomy (SILA) in 2009. This study compared perioperative outcomes between SILA and CLA to evaluate the usefulness of SILA.
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