Standardized patient care guidelines reduce infectious morbidity in appendectomy patients

Kenneth S. Helmer, Emily K. Robinson, Kevin P. Lally, J. C. Vasquez, Karen L. Kwong, Terrence H. Liu, David W. Mercer

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

Background: Surgical wound infection and intra-abdominal abscess remain common infectious complications after appendectomy, especially in the setting of a perforated or gangrenous appendix. We therefore developed a clinical protocol for the management of appendicitis to decrease postoperative infectious complications. Methods: Between January 1, 1999, and December 31, 1999, 206 patients with appendicitis were treated on protocol. Retrospectively, the charts were reviewed for all protocol patients as well as for 232 patients with appendicitis treated in the year prior to protocol initiation. Data were collected on surgical wound infections and intra-abdominal abscesses. Results: There were significantly fewer infectious complications in the protocol group than in the nonprotocol group (20 [9%] versus 8 [4%]; P <0.05). In patients with a perforated or gangrenous appendix, the infectious complication rate was reduced from 33% to 13% (P <0.05). Conclusions: The incidence of infectious complications after appendectomy can be significantly reduced with a standardized approach to antibiotic therapy and wound management.

Original languageEnglish (US)
Pages (from-to)608-613
Number of pages6
JournalAmerican journal of surgery
Volume183
Issue number6
DOIs
StatePublished - 2002
Externally publishedYes

Keywords

  • Algorithm
  • Antibiotics
  • Appendectomy
  • Perforated appendix
  • Secondary infectious peritonitis
  • Surgical complication

ASJC Scopus subject areas

  • Surgery

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