FREQUENCY OF SURGICAL SITE INFECTION IN PATIENTS UNDERGOING APPENDECTOMY WITH IMIPENEM SOLUTION WOUND IRRIGATION

Authors

  • S AFGAN Department of General Surgery, Saidu Group of Teaching Hospital Swat, Pakistan
  • F AKBAR Department of General Surgery, Saidu Group of Teaching Hospital Swat, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v5i02.183

Keywords:

Appendectomy, Surgical Site Infection, Wound Irrigation, Imipenem

Abstract

Background: Surgical site infection (SSI) remains a significant postoperative complication following appendectomy, leading to increased morbidity, hospital stay, and healthcare costs. The use of intraoperative antibiotic wound irrigation has been proposed to reduce infection rates, though its effectiveness varies across studies. Objective: To determine the frequency of surgical site infection in patients undergoing appendectomy with imipenem solution wound irrigation at Saidu Group of Teaching Hospital, Swat. Study Design: Descriptive study. Setting: Department of Surgery, Saidu Group of Teaching Hospital, Swat, Pakistan. Duration of Study: From 13-August-2024 to 13-February-2025. Methods: A total of 132 patients diagnosed with acute appendicitis based on clinical and ultrasonographic findings were enrolled. All underwent open appendectomy. Before skin closure, each surgical wound was irrigated with 1 L of normal saline containing 1 g of imipenem. Patients were followed for 30 days postoperatively for signs of SSI, which was diagnosed by the presence of purulent discharge, pain, redness, swelling, or warmth at the incision site. Data were analyzed using SPSS version 25, and associations between SSI and comorbid conditions were evaluated using the Chi-square test. Results: Of the 130 patients, 77 (58.3%) were males and 55 (41.7%) females, with a mean age of [insert mean ± SD if available] years. The overall SSI frequency was 9 (6.8%). Hypertension and diabetes mellitus were significantly associated with the development of SSI (p < 0.05). Conclusion: The incidence of surgical site infection following appendectomy with imipenem solution wound irrigation was 6.8%. The findings suggest that imipenem irrigation may effectively reduce SSI risk; however, comorbidities such as hypertension and diabetes remain significant contributing factors.

References

Catal O, Ozer B, Sit M, Erkol H. Is appendectomy a simple surgical procedure? Cir Ciruj. 2021;89(3):303–8. https://doi.org/10.24875/CIRU.20001277

Danwang C, Bigna JJ, Tochie JN, Mbonda A, Mbanga CM, Nzalie RN, et al. Global incidence of surgical site infection after appendectomy: a systematic review and meta-analysis. BMJ Open. 2020;10(2):e034266. https://doi.org/10.1136/bmjopen-2019-034266

Song MY, Ullah S, Yang HY, Ahmed MR, Saleh AA, Liu BR. Long-term effects of appendectomy in humans: is it the optimal management of appendicitis? Expert Rev Gastroenterol Hepatol. 2021;15(6):657–64. https://doi.org/10.1080/17474124.2021.1868298

Khan A. Frequency of histologically confirmed acute appendicitis in clinically diagnosed cases. Pak J Surg. 2022;38(4):230–3.

Danwang C, Bigna JJ, Tochie JN, Mbonda A, Mbanga CM, Nzalie RN, et al. Global incidence of surgical site infection after appendectomy: a systematic review and meta-analysis. BMJ Open. 2020;10(2):e034266. https://doi.org/10.1136/bmjopen-2019-034266

Labricciosa FM, Sartelli M, Barbadoro P, Abbo LM, Ansaloni L, Coccolini F, et al. Epidemiology and risk factors for superficial surgical site infections after appendectomy for acute appendicitis: a secondary data analysis. Surg Infect (Larchmt). 2021;22(2):227–33. https://doi.org/10.1089/sur.2020.069

Yang L, Zheng R, Li H, Ren Y, Chen H. The burden of appendicitis and surgical site infection of appendectomy worldwide. J Infect Dev Ctries. 2023;17(3):367–73. https://doi.org/10.3855/jidc.17605

Akbar K, Ullah F, Wahid A, Jamil T. Risk factors associated with surgical site infection post-appendectomy. Khyber J Med Sci. 2021;14(3):173–9.

Sarafi M, Azimi B, Karimian M, Ebrahimisaraj G. Incidence and risk factors for post-appendectomy emergency surgical site infections. Bull Emerg Trauma. 2025;13(3):153–7. https://doi.org/10.30476/beat.2025.106191.1582

Jumaah MD, Shuhata MH, Al-Hamndawee DM, Al-Ani II, Al-Hadeethi AM. Role of intraoperative antibiotics wound irrigation in reducing surgical site infection following open appendectomy: a randomized controlled trial. BMC Surg. 2025;25(1):369. https://doi.org/10.1186/s12893-025-03127-w

Aslam V, Bilal M, Ayaz M, Zaidi A, Gul L, Hasan S. The frequency of surgical site infections after irrigation of appendectomy wounds with sterile saline solution or imipenem solution is compared: a retrospective study. Med Forum Month. 2023;34(8):140–3. https://doi.org/10.60110/medforum.3408

Shah A, Sasoli NA, Sami F, Zai AR, Hanif M. Compare the incidence of surgical site infection after appendectomy wound irrigation with normal saline and imipenem solutions. Pak J Med Health Sci. 2021;15(8):2184–6. https://doi.org/10.53350/pjmhs211582184

Zeb A, Khan MS, Iqbal A, Khan A, Ali I, Ahmad M. Compare the frequency of surgical site infections following irrigation of appendectomy wounds with sterile saline solution vs imipenem solution. Pak J Med Health Sci. 2023;17(2):617–9. https://doi.org/10.53350/pjmhs2023172617

Khan S, Awan AS, Asad H, Khan R, Asad H. Intra-operative wound irrigation with normal saline solution versus topical antibiotics to avoid wound infection. Pak Armed Forces Med J. 2024;74(1):125–8. https://doi.org/10.51253/pafmj.v74i1.11737

Martin ET, Kaye KS, Knott C, Nguyen H, Santarossa M, Evans R, et al. Diabetes and risk of surgical site infection: a systematic review and meta-analysis. Infect Control Hosp Epidemiol. 2016;37(1):88–99. https://doi.org/10.1017/ice.2015.249

Amirah A, Harahap J, Willim HA, Suroyo RB, Henderson AH. Effect of comorbidities on the incidence of surgical site infection in patients undergoing emergency surgery: a systematic review and meta-analysis. J Clin Med Res. 2024;16(7–8):345–54. https://doi.org/10.14740/jocmr5222

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Published

2025-07-18

How to Cite

AFGAN , S., & AKBAR , F. (2025). FREQUENCY OF SURGICAL SITE INFECTION IN PATIENTS UNDERGOING APPENDECTOMY WITH IMIPENEM SOLUTION WOUND IRRIGATION. Pakistan Journal of Intensive Care Medicine, 5(02), 183. https://doi.org/10.54112/pjicm.v5i02.183

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Section

Original Research Articles