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A result of 70 relaparotomies performed after the operative intervention for acute appendicitis has been analysed. The causes and indications for reoperation, an outcome, nature of complications which required performance of relaparotomy have been considered. A classification of relaparotomies depending on time of their performance is suggested.
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The incidence of hospital and posthospital wound complications was studied in 236 patients, residents of Zelonograd, who underwent operation for acute appendicitis. The material was collected at City Hospital No. 3 and four out-patient clinics of Zelenograd. The incidence of suppuration of the surgical wound in the hospital period was 13.1%, that of nonpurulent complications was 9.3%, and the total incidence of the wound complications was 22.4%. In the posthospital period additional suppuration of wounds was encountered in 23.3% of patients, nonsuppurative wound complications in 17.1%, and the total incidence of posthospital wound complications was 40.3%. The frequency of rehospitalization was 5.5%, the incidence of postoperative hernias was 0.9%. The economical loss due to the development of wound complications in 236 patients operated on for acute appendicitis came up to 56,120 roubles.
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In this article, we present 80 noncomplicated acute appendicitis that we operated. The patients was separated into two groups. The first group, appendiceal stump was tied and dropped in abdominal cavity in 40 cases and second group, it was tied and inverted into the cecum in the other 40 cases. The cases were observed in the postoperative period concerning intraabdominal abscess, brid ileus, incisional wound infection and hospitalization duration. No significant difference has been found between these two groups.
The authors observations with prophylactic administration of metronidazole manufactured by the Gedeon Richter Company, Hungary (trade mark Klion) in children with phlegmonous appendicitis are reported. The drug was administered in three doses to 51 children. Results of bacteriology could be assessed in 42 children. The results of prophylactic administration of Klion in phlegmonous appendicitis were excellent. In our group there were no inflammatory wounds and/or intraperitoneal complications. For comparison, in a cohort of 1.008 children with phlegmonous appendicitis, without prophylaxis the rate of inflammatory complications was 3.62%. Klion has minimal side effects and is well tolerated and seems to be a superb drug for prophylaxis.
The paper reports the Authors' ten year experience on simple ligation in appendicectomy. After having reviewed the various surgical procedures, the Authors report their clinical experience and, considering the good postoperative results with this method, regard this procedure as an alternative to the technique of ligation with inversion of the stump in appendicectomy.