Role of Drainage of Preperitoneal Space in Postoperative Wound Sepsis
Journal of Surgery
Volume 4, Issue 1-1, January 2016, Pages: 11-15
Received: Aug. 14, 2015; Accepted: Aug. 15, 2015; Published: Sep. 8, 2015
Views 5063      Downloads 70
Authors
Emad K. Bayumi, Crimean Medical Academy Named After S.I. Georgiesky of Crimea Federal University, Crimea, Russia
Aly Saber, Port-Fouad General Hospital, Port-Fouad, Egypt
Article Tools
Follow on us
Abstract
Introduction: The incidence of surgical site infection increases with the degree of abdominal contamination. Previous studied claimed the effectiveness of putting a negative suction drain in the subcutaneous space in prevention of wound infection and wound dehiscence in patients of peritonitis. Aim was to study the effect of drainage of preperitoneal space in postoperative wound infection. Patients and Methods: A total of 200 patients with secondary peritonitis due to perforated appendicitis, perforated duodenal ulcers and traumatic bowel injuries were divided into main two groups; group A; wound closure with preperitoneal submuscular suction drainage and group B; wound closure without drain. End Points: The end points of the study were wound infection and time off from work. Results: The overall rates of wound infection in were 19% and 24% in group A and B respectively. Therefore the mean total hospital stay in both groups was 8.48 ±3 and 14.76±4.41days respectively. In the other hand, the mean time to return work after being discharged from the hospital was 8.5 ± 1.13 in group A and 8.59 ± 1.1 in of group B. The mean time off from work was 16.98 ± 4.13 days in group A and 23.38 ± 5.51 days in group B. Conclusion: Incidence of surgical site infection is high in case of complicated appendicitis and has its direct effect on the extent of hospital stay and time off from work and those with drainage of preperitoneal space showed more time of hospital stay and more time off from work.
Keywords
Preperitoneal Space, Drainage, Wound Sepsis
To cite this article
Emad K. Bayumi, Aly Saber, Role of Drainage of Preperitoneal Space in Postoperative Wound Sepsis, Journal of Surgery. Special Issue: Abdominal Surgery: Toward the Best. Vol. 4, No. 1-1, 2016, pp. 11-15. doi: 10.11648/j.js.s.2016040101.13
References
[1]
Ballus J, Lopez-Delgado JC, Sabater-Riera J, Perez-Fernandez XL, Betbese AJ, Roncal JA. Surgical site infection in critically ill patients with secondary and tertiary peritonitis: epidemiology, microbiology and influence in outcomes. BMC Infect Dis. 2015 Jul 30;15:304. doi: 10.1186/s12879-015-1050-5.
[2]
Sartelli M, Viale P, Koike K, Pea F, Tumietto F, van Goor H, Guercioni G, Nespoli A, Tranà C, Catena F, Ansaloni L, Leppaniemi A, Biffl W, Moore FA, Poggetti R, Pinna AD, Moore EE:WSES consensus conference: Guidelines for first-line management of intra-abdominal infections. World J EmergSurg 2011, 6:2.
[3]
De Ruiter J, Weel J, Manusama E, Kingma WP, van der Voort PH. The epidemiology of intra-abdominal flora in critically ill patients with secondary and tertiary abdominal sepsis. Infection. 2009; 37:522-7.
[4]
Augustin P, Kermarrec N, Muller-Serieys C, Lasocki S, Chosidow D, Marmuse JP, Valin N, Desmonts JM, Montravers P: Risk factors for multidrug resistant bacteria and optimization of empirical antibiotic therapy in postoperative peritonitis. Crit Care 2010, 14(1):R20.
[5]
Sartelli M, Catena F, Di Saverio S, Ansaloni L, Malangoni M, Moore EE, et al. Current concept of abdominal sepsis: WSES position paper. World J Emerg Surg. 2014 Mar 27. 9 (1):22.
[6]
Mazuski JE, Solomkin JS. Intra-abdominal infections. SurgClin North Am. 2009;89(2):421–437.
[7]
Rather SA, Bari SU, Malik AA, Khan A. Drainage vs no drainage in secondary peritonitis with sepsis following complicated appendicitis in adults in the modern era of antibiotics. World J Gastrointest Surg. 2013 Nov 27;5(11):300-5.
[8]
Petrowsky H, Demartines N, Rousson V, Clavien PA. Evidence-based value of prophylactic drainage in gastrointestinal surgery: a systematic review and meta-analyses. Ann Surg. 2004;240:1074-1084; discussion 1084-1085.
[9]
M Vashist. , A Singla, V Malik, M Verma. Abdominal Wall Closure In The Presence Of Sepsis: Role Of Negative Suction. The Internet Journal of Surgery. 2013 Volume 29 Number 1.
[10]
Farnell MB, Worthington-Self S, Mucha P Jr, Ilstrup DM, McIlrath DC: Closure of abdominal incisions with subcutaneous catheters. Arch Surg; 1986; 121: 641-48.
[11]
Mirilas P, Colborn GL, McClusky DA 3rd, Skandalakis LJ, Skandalakis PN, Skandalakis JE. The history of anatomy and surgery of the preperitoneal space. Arch Surg. 2005 Jan;140(1):90-4.
[12]
Motie MR, Ansari M, Nasrollahi HR. Assessment of surgical site infection risk factors at Imam Reza hospital, Mashhad, Iran between 2006 and 2011. Med J Islam Repub Iran. 2014; 28: 52.
[13]
Saber A, Ellabban GM, Gad MA and Elsayem K. Open preperitoneal versus anterior approach for recurrent inguinal hernia: a randomized study. BMC Surgery 2012, 12:22 doi:10.1186/1471-2482-12-22.
[14]
Omari AH, Khammash MR, Qasaimeh GR, Shammari AK, Yaseen MK, Hammori SK. Acute appendicitis in the elderly: risk factors for perforation. World J Emerg Surg. 2014 Jan 15;9(1):6. doi: 10.1186/1749-7922-9-6.
[15]
Katkhouda N,Mason RJ, Towfigh S,A,,and Essani R. Laparoscopic Versus Open Appendectomy, A Prospective Randomized Double-Blind Study. Ann Surg. 2005 Sep; 242(3): 439–450.
[16]
Stöltzing H1, Thon K. Perforated appendicitis: is laparoscopic operation advisable?. Dig Surg. 2000;17(6):610-616.
[17]
Aga E, Keinan-Boker L, Eithan A, Mais T, Rabinovich A, Nassar F. Surgical site infections after abdominal surgery: incidence and risk factors. A prospective cohort study. Infect Dis (Lond). 2015 Nov;47(11):765-71.
[18]
Korol E, Johnston K,Waser N,Sifakis F, Jafri HS, Lo M, and Kyaw MH. A Systematic Review of Risk Factors Associated with Surgical Site Infections among Surgical Patients PLoS One. 2013; 8(12): e83743.
[19]
Ortega G, Rhee DS, Papandria DJ, Yang J, Ibrahim AM, Shore AD, Makary MA, Abdullah F. An evaluation of surgical site infections by wound classification system using the ACS-NSQIP. J Surg Res. 2012 May 1;174(1):33-8.
[20]
ReichmanDE,and James A Greenberg JA. Reducing Surgical Site Infections: A Review. Rev Obstet Gynecol. 2009 Fall; 2(4): 212–221.
[21]
Wei HB, Huang JL, Zheng ZH, Wei B, Zheng F, Qiu WS, Guo WP, Chen TF, Wang TB. Laparoscopic versus open appendectomy: a prospective randomized comparison. Surg Endosc. 2010 Feb;24(2):266-9.
[22]
Krisher SL, Browne A, Dibbins A, Tkacz N, Curci M. Intra-abdominal abscess after laparoscopic appendectomy for perforated appendicitis. Arch Surg. 2001 Apr;136(4):438-41.
[23]
Cheng Y, Zhou S, Zhou R, Lu J, Wu S, Xiong X, Ye H, Lin Y, Wu T, Cheng N. Abdominal drainage to prevent intra-peritoneal abscess after open appendectomy for complicated appendicitis. Cochrane Database Syst Rev. 2015 Feb 7; 2:CD010168. Epub 2015 Feb 7.
[24]
Ballus J, Lopez-Delgado JC, Sabater-Riera J, Perez-Fernandez XL, Betbese AJ, Roncal JA. Surgical site infection in critically ill patients with secondary and tertiary peritonitis: epidemiology, microbiology and influence in outcomes. BMC Infect Dis. 2015 Jul 30;15:304. doi: 10.1186/s12879-015-1050-5.
[25]
Meagher H,Clarke Moloney M, Grace PA. Conservative management of mesh-site infection in hernia repair surgery: a case series. Hernia, 2015,19(2): 231-237
[26]
Yau KK, Siu WT, Tang CN, Yang GP, Li MK. Laparoscopic versus open appendectomy for complicated appendicitis. J Am Coll Surg. 2007 ;205(1):60-5.
[27]
Iqbal CW, Knott EM, Mortellaro VE, Fitzgerald KM, Sharp SW, St Peter SD..Interval appendectomy after perforated appendicitis: what are the operative risks and luminal patency rates? J Surg Res. 2012 Sep;177(1):127-30.
[28]
Gupta R, Sample C, Bamehriz F, Birch DW. Infectious complications following laparoscopic appendectomy. Can J Surg. 2006 Dec;49(6):397-400.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186