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[Predicting the course of wound healing after appendectomy using the hydroxyproline test].

A test for free hydroxyproline in blood plasma, urine, and wound exudate was conducted in a group of children who were operated on for acute catarrhal and destructive forms of appendicitis in an uncomplicated or complicated post-operative wound process. The changes in the concentration of the biochemical index were most regular in the wound exudate. Free hydroxyproline increased after the operation, reached highest values in 48 hours, and then reduced coming close to the control values 5-6 days after. In wound complications it increased three- to four-fold as compared to the control values, which could serve as an informative test in predicting the course of the postoperative wound process in children.

Acute Disease↗

[Single preoperative intravenous dose of metronidazole for appendectomy in children].

One hundred children were prophylactically treated with 15 mg/kg-1 of metronidazole immediately before appendicectomy and retrospectively compared with 100 other patients without any antibioprophylaxis. No statistically significant difference was found between the two groups as regards age, weight, sex and macroscopic appearance of the appendix. The overall incidence of complications was 1% in the antibioprophylactic group and 9% in the control group. Furthermore, a single pre-operative intravenous dose of metronidazole was as effective as conventional antibioprophylaxis.

Appendectomy↗

Post-appendectomy wound infection, a solved problem?

Over a 3.5 year period, 550 patients underwent an emergency operation under the diagnosis of acute appendicitis. The appendix proved to be normal in 82 patients, the other 468 patients had signs of acute inflammation with perforation in 142 cases. Management followed a strict protocol with single dose metronidazole as preoperative antibiotic prophylaxis and liberal open wound treatment in case of gross contamination. Consequently, the subcutaneous tissues and the skin were left open in 218 patients. The overall wound infection rate (1.3%) and the intra-abdominal abscess rate (1.1%) were extremely low. Open wound treatment was well accepted by the patients, did not prolong the hospital stay and gave good cosmetic results.

Acute Disease↗

[Complications of appendectomy during pregnancy].

A retrospective investigation revealed that in 11 out of 23 pregnant women submitted to operation on account of suspected appendicitis the diagnosis could be confirmed. The perinatal and the maternal mortalities were both 0. In the women submitted to operation, the frequency of obstetric complications was found to be 17%, 95% confidence limits 5-39%, and the frequency of surgical complications was 17%, 95% confidence limits 5-39%. The diagnostic specificity was found to be significantly higher in women who had previously born children. Brief duration of symptoms preoperatively and operation employing beta-sympathomimetics are recommended.

Adult↗

[The role of real-time sonography in the differential diagnosis of acute appendicitis and in the detection of post-appendectomy complications].

110 urgent sonography were performed on 101 patients with suspected acute appendicitis and on subsequent 26 patients 33 echography with suspected postappendectomy abscess. Although according to a few publications in connection with acute appendicitis there are characteristic sonographic signs, the authors didn't find any typical structures at patients having non-complicated appendicitis. But at perforated appendicitis and periappendicular abscesses the fluid collection was frequently very well visualizable and the periappendicular infiltration was detectable as well. The differentation between infiltration and abscess is difficult, often unsuccessfull. The authors confirm the high sensitivity of sonography in the detection of postappendectomy intraabdominal abscesses, similarly to other abscesses of unrelated origin. They emphasize the differentialdiagnostic aid of sonography, if the clinical symptoms are atypical or the signs of acute appendicitis are imitated by other disease.

Acute Disease↗