ESCP 2015 Dublin Sissel Ravn Millie Ngaage Dave Golding Carl-Philip Rancinger Merle Stellingwerf
Post appendectomy wound infection
PICO Patients: Non-perforated appendectomy patients Intervention: Antibiotic prophylaxis Comparison: No treatment/ placebo Outcome: Postoperative infections
Introduction Appendicitis most common cause of acute abdominal pain requiring surgery Site infection is the most common complication in surgery Infections increase morbidity, mortality, length of hospital stay and health care cost¹, ² Studies showed prophylactic antibiotics to be effective in reducing post operative infections³ What would be the outcome of a pan-European study?
Aim Primary Evaluate the value of prophylactic antibiotics in reducing post operative site infections in patients requiring appendectomy Secondary Compare open and laparoscopic appendectomy with regard to site infections Evaluate the diagnostic method: Clinically or CT-scan
Method Prospective - 2 week capture period Patient population: patients with non-perforated appendicitis who undergo open or laparoscopic appendectomies, 18+ Variables: experience of surgeon Follow up: 3 month period Inclusion/exclusion criteria: Exclude patients with T2DM, previous transplants, HIV status Primary outcome measures: Southampton wound score? Or define our own parameters? (i.e. positive bacteria culture, extended hospital stay, persistent pyrexia, presence of pus). Outcome assessed by a blinded clinician
Perspectives Establish a European database Expand the method to other populations
Any questions or input?
References 1. Barie PS. Surgical site infections: Epidemiology and prevention. Surg Infect 2002;3(Suppl 1):S9–S Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999;20:250– Andersen BR, Kallehave FL, Andersen HK. Antibiotics versus placebo of postoperative infection after appendicectomy. Cochrane Database Syst Rev Jul 20;(3): CD