Humberto Guanche Garcell; Ariadna Villanueva Arias; Cristobal A. Pancorbo Sandoval; Adam Bode Sado; Ramón Nonato Alfonso Serrano; Francisco Gutierrez García
Abstract
Background: Identifying risk factors for surgical site infection (SSI) after appendectomies could be useful in focusing prevention programs. Objective: The current study aimed to identify the risk factors associated with SSI in a cohort of patients from a single center in Western Qatar. Methods: This ...
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Background: Identifying risk factors for surgical site infection (SSI) after appendectomies could be useful in focusing prevention programs. Objective: The current study aimed to identify the risk factors associated with SSI in a cohort of patients from a single center in Western Qatar. Methods: This cross-sectional study was carried out at The Cuban Hospital (Dukhan, Qatar) on patients who had undergone an appendectomy from January 2013 through September 2016. Data extracted from the patient files included demographics, comorbidities and toxic habits, surgery type, procedure duration, wound type, appendicitis-type, American Anesthesiology Score, body mass index, selected laboratory tests, and compliance with antibiotic prophylaxis. Results: The study variables, type of surgery performed, procedure duration, wound and appendicitis type, serum albumin, and timing of antibiotic prophylaxis, were found to be related to the occurrence of SSI in univariate analysis (P = 0.000). Logistic regression showed that open appendectomies (odds ratio [OR] = 22.90, 95% CI; 8.04-65.21), low serum albumin (OR = 0.92, 95% CI; 0.85-0.99), and improper timing of antibiotic prophylaxis (OR = 44.92, 95% CI; 3.39-594.91) were independently associated with the occurrence of SSI. Conclusion: Cases of complex appendicitis, open procedure, low serum albumin level, and improper timing of antibiotic prophylaxis constituted the risk factors for SSI in the setting of this study. The infection control program should focus on improving the quality of antibiotic prophylaxis and closely monitoring patients who undergo open surgical procedures.
Soleiman Hosseini Khalifani; Soleiman Heydari; Mehdi Morshedi; Hassan Ali Mohebi; Gholamali Ghorbani; Shahram Manoochehry
Abstract
Background: Acute appendicitis is one of the most common acute surgery events. Its main treatment is surgery. However medical management before and after the surgery has an important impact on the treatment. Objective: The aim of study was evaluating the outcomes of single dose and quadruple doses of ...
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Background: Acute appendicitis is one of the most common acute surgery events. Its main treatment is surgery. However medical management before and after the surgery has an important impact on the treatment. Objective: The aim of study was evaluating the outcomes of single dose and quadruple doses of prophylactic antibiotic therapy in patients with acute non-complicated appendicitis. Methods: This randomized double blind clinical trial was carried out on 294 patients in single dose (136 patients) and the quadruple doses (158 patients) groups. In single dose group, a dose of 1g Cefazolin + 500mg Metronidazole was prescribed intravenously about half an hour before surgery. The quadruple doses group received three more doses after surgery. Two groups were followed for fever, erythema, seroma, wound infection, intra-abdominal abscess formation and readmissions within one month after discharge. Results: The mean age of patients was 31±5.14 years. 203(69%) of patients were men while 91(31%) were women. There were no significant statistical differences between groups in age, sex and body mass index (BMI) variables. No significant statistical differences were observed during surgery and hospitalization period between two groups. In the single dose group, wound infection was 8(5.9%), while it was 6(3.8%) in the quadruple doses group; hence, there were no significant statistical differences in this regard. There was no abdominal abscess in groups. There were significant statistical differences regarding erythema, seroma and antibiotics consumption costs between groups. Conclusion: A single dose of prophylactic antibiotics is sufficient in patients with acute suppurative non-complicated appendicitis.