Our Summary

This study examines whether a specific technique used during appendectomy surgeries (removal of the appendix) can help reduce the risk of infection in the abdomen. When performing an appendectomy, surgeons may choose to use a technique called irrigation, which involves washing the area with fluid. The need for this technique has been a topic of debate, as recent studies have suggested it doesn’t provide any benefit. In this study, the researchers compared two methods: one where the surgeon decided whether to use irrigation, and another where irrigation was standardized and used a large amount of fluid.

The researchers looked back at medical records from 2007 to 2017 of 432 patients who had appendectomies for acute appendicitis. They then compared the rates of abdominal infection in patients who had the standardized large volume irrigation technique versus those who did not.

The results showed that patients who underwent the standardized large volume irrigation technique had no subsequent abdominal infections, while 6.2% of the other patients did. This difference was even more significant in cases where the appendix had ruptured before surgery.

The researchers concluded that the standardized large volume irrigation technique is associated with a lower rate of abdominal infection. However, they noted that more research is needed to confirm these findings.

FAQs

  1. What is the irrigation technique used in appendectomy surgeries?
  2. Was there a significant difference in abdominal infection rates between the two appendectomy techniques studied?
  3. What was the conclusion of the study on the use of standardized large volume irrigation technique during appendectomies?

Doctor’s Tip

Therefore, it is important for patients undergoing an appendectomy to discuss with their surgeon the use of the standardized large volume irrigation technique to help reduce the risk of abdominal infection. It is always important to follow your doctor’s recommendations and discuss any concerns or questions you may have about your surgery.

Suitable For

Patients who are typically recommended for an appendectomy are those who are diagnosed with acute appendicitis, which is inflammation of the appendix. In some cases, a ruptured appendix may also require surgical removal. In this study, the researchers specifically looked at patients with acute appendicitis who underwent appendectomy surgery.

Timeline

Before appendectomy:

  • Patient experiences symptoms of appendicitis such as abdominal pain, nausea, vomiting, and fever.
  • Patient seeks medical attention and undergoes physical examination, blood tests, and imaging studies to confirm the diagnosis.
  • Surgeon recommends appendectomy as treatment for acute appendicitis.
  • Patient undergoes pre-operative preparations such as fasting and receiving anesthesia.

After appendectomy:

  • Patient undergoes the surgical procedure to remove the inflamed appendix.
  • Surgeon may choose to use irrigation technique during the surgery to wash the area with fluid.
  • Patient is monitored in the recovery room for any immediate complications.
  • Patient is discharged from the hospital within a few days and instructed on post-operative care.
  • Patient may experience pain, discomfort, and limited activity for a period of time after surgery.
  • Patient follows up with the surgeon for any complications or concerns.
  • Patient gradually resumes normal activities as they recover from the surgery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about appendectomy in light of this study include:

  1. What technique will be used during my appendectomy surgery? Will irrigation be used, and if so, what volume of fluid will be used?
  2. What are the potential risks and benefits of using irrigation during the surgery?
  3. Based on this study, do you recommend using the standardized large volume irrigation technique for my surgery?
  4. Are there any alternative techniques or methods that could be used to reduce the risk of infection?
  5. How likely am I to experience complications or infections after the surgery, and what steps will be taken to prevent them?
  6. Are there any additional steps I can take before or after the surgery to reduce the risk of infection?
  7. Will I need to take any specific precautions or follow-up care to monitor for signs of infection after the surgery?

Reference

Authors: LaPlant MB, Saltzman DA, Rosen JI, Acton RD, Segura BJ, Hess DJ. Journal: J Pediatr Surg. 2019 Apr;54(4):728-732. doi: 10.1016/j.jpedsurg.2018.06.017. Epub 2018 Jun 27. PMID: 30025605