14. To Compare the Frequency of Superficial Surgical Site Infection After Laparoscopic Versus Open Appendectomy
1. Imran Khan 2. Muhammad Iqbal Khan 3. Muhammad Jawed 4. Ubedullah Shaikh
5. Saeed Ahmed 6. Anum Arif
1. Registrar, Jinnah Postgraduate Medical Centre, Karachi 2. Senior Registrar Surgery, Jinnah Postgraduate Medical Centre, Karachi 3. Asstt. Prof. of Surgery & Bariatric Surgeon, Dow University Hospital OJHA Campus Karachi
4. Senior Medical Officer of Surgery, Dow University Hospital OJHA Campus Karachi 5. Asstt.0 Prof. of Surgery,
Abbasi Shaheed Hospital, KMDC Karachi 6. PG Student of General Surgery, Dow University Hospital OJHA Campus Karachi
Objective: To compare the frequency of Superficial Surgical Site infection after laparoscopic versus open appendectomy.
Study Design: Randomized clinical trial study
Place and Duration of Study: This study was conducted at Surgical Department Jinnah Post Graduate Medical Centre Karachi and Dow University Hospital from August 2013 to January 2014.
Materials and Methods: The source of data was patients admitted in emergency. Patients were selected on the basis of clinical features. The data was collected with the help of Performa attached. It included demographic data of the patient, presenting complaints, operative findings, Surgical site infection. Random patients were placed in two groups. Surgical site infection by observation of pain, redness, tenderness and purulent discharge from the wound. Patients included were of both gender and age above 13 years presented to emergency department diagnosed as acute appendicitis on the basis of history and examination and exclusion of under 12 years of age, appendicular mass, CLD, I.H.D , DM and renal failure.
Results: Out of 270 patients, 153(56.7%) patients were males and 117(43.3%) patients were female. In Present study the different operative findings with their distribution among gender are shown in table. In other findings three patients with ruptured ovarian cyst and one with Mackel’s Diverticulitis in which procedure was converted to open and resection and anastomosis of small intestine was done. SSSI is found to associated with operative finding with a significant P value 0.001.
Superficial Surgical Site Infection were observed in both procedure laparoscopic appendectomy allotted in 134 cases but four cases are converted to open procedure so they are excluded from the results. The reason for conversion in three cases was difficulty in mobilizing the appendix because of adhesion and in one case Mackel’s Diverticulitis found which need open procedure for formal small intestine resection and anastomosis. Superficial Surgical Site Infection was observed in three cases of Laparoscopic appendectomy and in 15 cases of Open Appendectomy group with the P value 0.005.
Conclusion: Laparoscopic appendectomy is a better choice because of its reduced frequency of SSSI when compared with open procedure. SSSI is an important complication.
Key Words: Appendicitis, Laparoscopic Appendectomy, Open Appendectomy, SSSI