천공성 충수돌기염 수술 시 복강 세척 후 감염성 합병증 발생
Peritoreal Saline Irrigation and Infective Complications in Perforated Appendicitisin at a Single Center
이환봉, 이병찬, 이재규,
소속 상세정보
이환봉 ( )
원광대학교 의과대학 외과학교실
이병찬 ( )
원광대학교 의과대학 외과학교실
이재규 ( )
원광대학교 의과대학 응급의학교실
KMID : 0371320030650050425
Abstract
Purpose: Until recently, the surgical treatment of perforated appendicitis in South Korea showed a relatively high incidenece of postoperative infectious complications compared with centers having protocols for managements. Authors have been performing appendectomies for perforated cases under the principle of massive irrigation of the peritoneal cavity and primary closure of incision wound that leaves a suction drain from pelvic cavity, expecting reducing chance of infective complications and thus reducing the stress faced by operators.
Methods: Among 788 cases of appendicitis from September 1997 to December 2002, 172 patients showing perforation and penitonitis in the operative field were reviewed retrospectively. All the operations were performed by the principle mentioned above, and data were collected on various major complications, especially infective wound and intra-abdominal complications.
Results: There were 7 cases of suppurative wound infection, and 5 cases of intra-abdominal abscess, representing a total incidence of 7.0% (n=12) in 172 patients. Other major complications such as adhesive ileus (n=3), intestinal fistula (n=1), or remote organ infective event (n=1) were also recognized.
Conclusion: Massive saline irrigation during appendectomy of perforated appendicitis-without antibiotic mixture-that leaves a negative suction drain from the pelvic cavity and the primary closure of incision wounds have yielded satisfactory results concerning various aspects, especially in lessening infective postoperative complications.
키워드
천공성 충수돌기염;창상감염;복강내농양;세척;일차봉합;Perforated appendicitis;Wound infection;Intra-abdominal abscess;Irrigation;Primary closure
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