ปัจจัยเสี่ยงและอัตราการเกิดแผลติดเชื้อหลังจากเย็บปิดแผลผ่าตัดทันทีของการผ่าตัดโรคไส้ติ่งอักเสบแบบซับซ้อน ในโรงพยาบาลพระนครศรีอยุธยา

Phrompirun  Wattanawiggid

Authors

Phrompirun Wattanawiggid Phra Na Khon Si Ayutthaya hospital

Keywords:

surgical site infection, complicated appendicitis, perforated appendicitis, primary wound closure, delay primary wound closure

Abstract

Objective : To study the rate and factors affecting surgical site infection after primary wound closure in complicated appendicitis patients who underwent appendectomies in Phra Na Khon Si Ayutthaya Hospital

Method : Adult patients diagnosed with complicated appendicitis and underwent appendectomies by two surgeons from June 2016 to July 2019 were retrospective review. The characteristic of the patient included demographic data, white blood cell count, diabetic and HIV status, history of smoking, primary diagnosis, the severity of complicated, intensive care unit admission, length of stay, type of operation, a technique of wound closure (primary or delay), pathological finding, and surgical site infection (SSI).

Result : The 176 patients with complicated appendicitis were reviewed (107 Males) with a mean age of 43.9+18.7 years. Complicated appendicitis in this group combined with 67 ruptured, 96 gangrenous and 13 appendices abscesses. Patients who had BMI above 25 kg/m2 were 36. 4 %. Incisions were performed at the right lower quadrant abdomen at about 84. 1 %. Primary wound closure was done in 83. 5 %. The mean length of stay is 4.7 days after surgery. The overall surgical site infection rate is 6.5 % with 6.4 % in the perforated group. Primary wound closure is only one factor related lower SSI in complicated appendicitis.

Conclusion : The rate of surgical wound infection after primary closure appendectomy wound of complicated appendicitis patient in Phra Na Khon Si Ayutthaya Hospital was 6.5 %. Primary wound closure after appendectomy is one factor that affected the lower rate of SSI compare to delay closure.

Keywords : surgical site infection, complicated appendicitis, perforated appendicitis, primary wound closure, delay primary wound closure

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