Jm. Badia et al., RANDOMIZED PROSPECTIVE-STUDY ON ANTIBIOTI C-PROPHYLAXIS COMPARED WITHLAVAGE OF THE SURGICAL-WOUND IN UNPERFORATED APPENDICITIS, Medicina Clinica, 103(6), 1994, pp. 201-204
BACKGROUND:: There are many doubts as to the efficacy of systemic anti
biotic prophylaxis venus the methods of local treatment in the prevent
ion of infection of the contaminated surgical wound. A controlled pros
pective study was designed to compare the effectiveness of a combinati
on of parenteral antibiotics with ravage with physiologic serum of the
surgical wound to prevent Infection of the postappendectomy wound. ME
THODS: The patients in group A (antibiotic, n = 70) received a sole pr
eoperative dose of methronidazol and gentamicin while In those in grou
p I (irrigation, n = 71) the wounds were irrigated with physiologic se
rum prior to and following closure of aponeurosis. The patients were c
ontrolled at one week and one month after the intervention. RESULTS: T
he global rate of infection was 9.3%. Six patients of group A and five
of group I developed wound Infection (p = 0.06), The age and length o
f the intervention were significantly higher in the infected patients
(41 vs 23 years, p = 0.0001 and 53 vs 41 minutes, p = 0.03, respective
ly). Intraperitoneal culture was positive in 70% of the patients who p
osteriorly developed wound infection, being positive in only 9.4% of t
he unifected patients (p = 0.0001). Eight of the infections (73%) were
detected following discharge from hospital. The cost of prophylaxis i
n group A was seven-fold higher than that of group I. CONCLUSIONS: Lav
age of the surgical wound with physiologic serum may be an effective,
safe and inexpensive method to prevent Infection of the wound followin
g appendicectomy for unperforated appendicitis.