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KMID : 0371619990150020235
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Journal of Wonkwang Medical Science
1999 Volume.15 No. 2 p.235 ~ p.240
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The Effect of Massive Saline Irrigation and Primary Closure in Perforated Appendicitis
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Lee Hwan-Bong
Lee Jai-Kyoo
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Abstract
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Background: Large proportion of patients of perforated appendicitis are still suffering from postoperative infectious complications such as wound infection and intraabdominal abscess. Inspite of various efforts against above complications there leaves much things to be settled for better results of treatment
Methods: By one surgeon and by one operative principle throughout the period, 91 cases of perforated appendicitis were underwent surgical intervention from September 1997 to August 1999. all patients of perforated appendicitis had appendectomy and intraperitoneal closed suction drainage from pelvic cavity with massive saline wound irrigation after peritoneal approximation. A penrose drain was also left in primarily closed incision wound for several days in all patients. In case of diffuse peritonitis, saline irrgation of intraperitoneal cavity was made and the presence of fecalith or not was always checked by the operator.
Results: Postoperative suppurative wound infection appeared in 6 patients (6.6%) and intraabdomonal abscess appeared in 3 patients (3.3%)
Conclusions: Massive saline irrigation in peritoneal cavity and incision wound markedly reduces infective complications in perforated appendicitis patients comparing previous results and shows better results comparing generalized method of delayed primary closure of comtaminated wound.
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KEYWORD
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perforated appendicitis, wound irrigation, primary closure, wound infection
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