372. Effect of in-hospital delay on wound infection in acute appendicitis
Session: Poster Abstract Session: HAI: Surgical Site Infections
Thursday, October 8, 2015
Room: Poster Hall
Background: Delay in diagnosis and treatment in patient with appendicitis are associated with increasing morbidity and mortality. Urgent appendectomy has become the basis of management for acute appendicitis. Effect of in-hospital delay such as investigation time, waiting, and referring time for operation may increase the rate of complicated appendicitis and wound infection. However, recent data suggests that delaying operative intervention for acute appendicitis to accommodate a surgeon's preference or to maximize a hospital's efficiency did not increase risk to the patient. The purpose of this study was to investigate the association between time from diagnosis to operation and surgical site infection (SSI) in patients with appendicitis.

Methods: Patients undergoing appendectomy January 2012- December 2014 were included in prospective study. We collected and analyzed data on patient demographics; length of symptoms; times of presentation, admission and surgery; antibiotic administration; operative findings; and occurrence of SSI. Comparison of data between two groups was undertaken with chi-square tests for categorical data and student’s t-test or Mann-whitney test for continuous data. The p value of less than 0.05 was considered statistically significant.

Results: In 400 patients (234 female (58.5%) and 166 male (41.5%)) who underwent appendectomies the average age was 41.48 year old. Ruptured appendicitis was found in 106 patients (26.5%). Group I included patients who underwent appendectomy within 12 hours of diagnosis and group II included those appendectomies performed greater than 12 hours after diagnosis. . The operative time (50.14 vs 57.7 minutes), length of stay (2.65 vs 2.09 days), wound infections (4 vs 6), and antibiotic use at discharge (19 vs 3) for group I and II were not statistically different.

Conclusion: In-hospital delay more than 12 hours was not associated with significantly higher risk of SSI in patients who underwent appendectomies.

Chumpon Wilasrusmee, MD, Siwakhom Chaiprasertwit, MD and Napaphat Poprom, BSc, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Disclosures:

C. Wilasrusmee, None

S. Chaiprasertwit, None

N. Poprom, None

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