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conferenceseries.com
November 28-29, 2016 Valencia, Spain
4th World Congress on
Infection Prevention and Control
Volume 4, Issue 8 (Suppl) J Infect Dis Ther 2016
ISSN: 2332-0877, JIDT an open access journal Infection Control 2016
November 28-29, 2016
Management of perforated appendicitis in children and infection prevention
Nasim Mohamad Alsebai and Abdulrahim Abu Jayyab
Emirates College of Technology, UAE
Perforated appendicitis in children continues to be associated with significant morbidity. In 2012, a treatment algorithm was begun
at the author's institution, which included immediate appendectomy, antibiotic irrigation of the peritoneal cavity, trans-peritoneal
drainage through the wound and 10-day treatment with intravenous ampicillin, clindamycin and gentamicin. Initial results with this
scheme in 27 patients demonstrated a 7.7% incidence of major complications and no deaths. From 2012 through 2016, the authors
continued to use this treatment plan in all patients with perforated appendicitis. 73 patients with perforated appendicitis were treated
and the rate of major complications was 6.4%. Infectious complications occurred in 18 patients (4.8%) and included intra-abdominal
abscesses (2 patients, 1.3%), phlegmon treated with an extended course of antibiotics (2 patients, 1.6%), wound infections (5 patients,
1.3%) and entero-cutaneous fistula requiring further operations (2 patients, 0.5%). There were six cases of small bowel obstruction
(1.6%), which required operative intervention. There were no deaths. The average length of stay of all patients was 11.4 days (range,
8 to 66 days). Utilization of trans-peritoneal drainage and choice of antibiotic therapy continue to be sources of controversy in the
surgical literature. However, the treatment plan used in the present study resulted in the lowest complication rate reported to date
and the authors conclude that this scheme in truly the “gold standard” for treatment of perforated appendicitis. New treatment plans
using laparoscopic appendectomy, different or shorter courses of antibiotics or not using drain should have complication rates that
are as low as or lower than this one to be considered as useful alternatives.
Biography
Nasim Mohamad Alsebai is a Pediatric Surgeon, Anatomist, Researcher and Lecturer. Nasim has graduated from Faculty of Medicine, Aleppo University and did
Pediatric Surgery Residency Training in Syria from Aleppo University Hospital, Faculty of Medicine where Nasim obtained Master’s degree in Surgery-Pediatric
Surgery followed by Master of Science degree in Human Anatomy from the Anatomy Department, Aleppo University. Nasim is currently working as an Anatomy
Lecturer in the College of Medical & Health Sciences in Emirates College of Technology, Abu Dhabi. Nasim is actively involved in clinical research and academic
publications.
Nasim Mohamad Alsebai et al., J Infect Dis Ther 2016, 4:8 (Suppl)