Wertigkeit klinischer, laborchemischer und sonographischer befunde bei der akuten appendizitis — Einfluß der chirurgischen erfahrung und der bakteriologischen diagnostik auf die rate der wundheilungsstörungen
✍ Scribed by F. Kallinowski; H. Buhr
- Publisher
- Springer
- Year
- 1992
- Tongue
- English
- Weight
- 711 KB
- Volume
- 377
- Category
- Article
- ISSN
- 1435-2451
No coin nor oath required. For personal study only.
✦ Synopsis
for acute appendicitis. Neither the physical examination nor laboratory results were unequivocally diagnostic in a third of the patients. The ultrasonographic visualization of the inflamed appendix could confirm the diagnosis in 50% of the clinically doubtful cases (predictive value: 84 %). Further diagnostic procedures were rarely necessary. The perforation rate was independent of the duration of the preoperative hospitalization due to the rapid surgical treatment. Contrary to previous reports, the likelihood of an intraoperatively innocent appendix increased with delayed surgery. Wound infection rates were similar after appendectomies by surgeons in training and by fully qualified surgeons although perforated appendices were typically removed by the latter ones. Antibiotic therapy was usually administered for severely inflamed appendices depending on the intraoperative findings and for perforated appendices and reduced the rate of wound infections if more than two bacteria had been cultured from a routine intraoperative swab. The documentation used in Baden-Wfirttemberg for quality control should include the result of an intraoperative appendiceal swab.