Systematic Review Sissel Breivold Roland, Are Hugo Pripp ...
ESCP 2015 Dublin Sissel Ravn Millie Ngaage Dave Golding Carl-Philip Rancinger Merle Stellingwerf.
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ESCP 2015 Dublin Sissel Ravn Millie Ngaage Dave Golding Carl-Philip Rancinger Merle Stellingwerf
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Transcript of ESCP 2015 Dublin Sissel Ravn Millie Ngaage Dave Golding Carl-Philip Rancinger Merle Stellingwerf.
ESCP 2015DublinSissel RavnMillie NgaageDave GoldingCarl-Philip RancingerMerle Stellingwerf
Post appendectomy wound infection
PICO
Patients: Non-perforated appendectomy patients
Intervention: Antibiotic prophylaxis
Comparison: No treatment/ placebo
Outcome: Postoperative infections
Introduction
Appendicitis most common cause of acute abdominal pain requiring surgery
Site infection is the most common complication in surgery
Infections increase morbidity, mortality, length of hospital stay and
health care cost¹, ²
Studies showed prophylactic antibiotics to be effective in reducing post operative infections³
What would be the outcome of a pan-European study?
AimPrimary
- Evaluate the value of prophylactic antibiotics in reducing post operative site infections in patients requiring appendectomy
Secondary
- Compare open and laparoscopic appendectomy with regard to site infections
- Evaluate the diagnostic method: Clinically or CT-scan
Method
Prospective - 2 week capture period
Patient population: patients with non-perforated appendicitis who undergo open or laparoscopic appendectomies, 18+
Variables: experience of surgeon
Follow up: 3 month period
Inclusion/exclusion criteria: Exclude patients with T2DM, previous transplants, HIV status
Primary outcome measures: Southampton wound score? Or define our own parameters? (i.e. positive bacteria culture, extended hospital stay, persistent pyrexia, presence of pus).
Outcome assessed by a blinded clinician
Perspectives
- Establish a European database
- Expand the method to other populations
Any questions or input?
References
1. Barie PS. Surgical site infections: Epidemiology and prevention. Surg Infect 2002;3(Suppl 1):S9–S21. 2. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999;20:250–278.3. Andersen BR, Kallehave FL, Andersen HK. Antibiotics versus placebo of postoperative infection after appendicectomy. Cochrane Database Syst Rev. 2005 Jul 20;(3): CD001439.
