Subcuticular skin closure as a standard approach to emergency appendectomy in children: prospective clinical trial.

Abstract:

:We evaluated the morbidity associated with primary closure by interrupted subcuticular absorbable sutures following emergency appendectomy. In a prospective clinical trial over a 12-month period, 216 children who underwent emergency appendectomy had skin closure using subcuticular interrupted absorbable polyglactin 4-0 sutures. Preoperative prophylactic antibiotics consisting of metronidazole alone or in combination with gentamicin were used in patients with suspected phlegmonous appendicitis; a combination of metronidazole, gentamicin, and ampicillin was used when perforation of the appendix was suspected. Postoperatively, in patients with phlegmonous appendicitis metronidazole was given for 24 hours, whereas in those with peritonitis the triple antibiotics were continued for 7 to 10 days. All patients were assessed for complications resulting from the technique of wound closure. No intraabdominal abscesses or serious complications were recorded. The overall incidence of wound infection was 1.8%. Among children with a perforated appendix the rate of superficial wound infection was 5.7%. There was no difference in the rate of wound infection between patients who received metronidazole alone or metronidazole plus gentamicin preoperatively. All the patients and their families were satisfied with the cosmetic results and with the fact that removal of skin sutures was unnecessary. We conclude that the use of prophylactic antibiotics permits standard skin closure by interrupted absorbable subcuticular suture.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Serour F,Efrati Y,Klin B,Barr J,Gorenstein A,Vinograd I

doi

10.1007/s002689900007

subject

Has Abstract

pub_date

1996-01-01 00:00:00

pages

38-42

issue

1

eissn

0364-2313

issn

1432-2323

journal_volume

20

pub_type

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    pub_type: 杂志文章

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    更新日期:2006-08-01 00:00:00

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    更新日期:2009-07-01 00:00:00

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