대한대장항문학회

Infectious complications such as wound infection and intra-abdominal abscess are<br>rarely fatal, but perplexing to both patients and surgeons, and still remain asserious<br>problem after appendectomy in about 5% of the patients.<br>To be helpful to reduce post-appendectomy complications, authors retrospectively<br>analyzed 229 cases of appendectomy performed during the period of one year, from<br>January 1 through December 31, 1995, to find out contributing factors to the<br>post-appendectomy infectious complications such as wound infection or intra-abdominal<br>abscess.<br>The results were as follows.<br>1) Infectious complications are more common in patients with four or more days of<br>symptom.<br>2) Infectious complications are more common in patients with complicated appendicitis<br>such as gangrenous or perforated appendicitis.<br>3) Preoperative antibiotics are helpful to prevent infectious complications in cases of<br>complicated appendicitis.<br>4) There is no difference in the incidence of infectious complications between the<br>immediate operations and overnight delayed operations in patients who were admitted in<br>the late evening or at night.<br>5) There is no difference in the incidence of infectious complications between<br>operators: staff surgeons who exclusively operated on patients with complicated<br>appendicitis and residents(with or without supervision of staff surgeons) who mostly<br>operated on patients with simple appendicitis. This means technical superiority has its<br>role in preventing infectious complications.<br>Early diagnosis and operation before the gangrenous change or perforation are<br>warranted. Preoperative antibiotics are effective in cases of complicated appendicitis, but<br>not in cases of simple appendicitis. But the lack of objective criteria to decide<br>complicated appendicitis before the operation remains problem, and prospective study to<br>solve this problem is needed.<br>Technical perfectness is required to protect the wound and to remove the appendix<br>without contamination. Preventive measures are also important to prevent the infectious<br>complications in cases of inevitably contaminated wounds or inta-abdominal spaces.<br>