BACKGROUND/ PURPOSE: Variation exists among pediatric surgeons in the management of pediatric appendicitis. The goal of this study was to determine current practice patterns and provide a foundation for evidence-based outcome studies that would standardize patient care. METHODS: Members of the American Pediatric Surgical Association (APSA) were surveyed. Data included preference of imaging, timing of operation, and opinions on interval appendectomy. Intraoperative principles surveyed included use of cultures, antibiotic irrigation, transperitoneal drains, and method of wound closure. Spectrum and duration of antibiotic coverage were assessed, as were discharge criteria. RESULTS: Survey response was 70%. A majority prefers computerized tomographic (CT) imaging and favors interval appendectomy in appropriate candidates. Seventy percent indicate a stable child with suspected appendicitis would be operated on in a semiurgent manner rather than emergently in their practice. Discrepancy exists in the type and duration of antibiotic coverage, impact of clinical parameters on antibiotic use, and utility of discharge criteria. CONCLUSIONS: This study consolidates current opinions on appropriate management of pediatric appendicitis, providing a foundation for evidence-based outcome studies capable of bringing conformity to the management of this surgical disease. Such studies would establish clinical practice guidelines that optimize resource utilization while maintaining quality care.
BACKGROUND/ PURPOSE: Variation exists among pediatric surgeons in the management of pediatric appendicitis. The goal of this study was to determine current practice patterns and provide a foundation for evidence-based outcome studies that would standardize patient care. METHODS: Members of the American Pediatric Surgical Association (APSA) were surveyed. Data included preference of imaging, timing of operation, and opinions on interval appendectomy. Intraoperative principles surveyed included use of cultures, antibiotic irrigation, transperitoneal drains, and method of wound closure. Spectrum and duration of antibiotic coverage were assessed, as were discharge criteria. RESULTS: Survey response was 70%. A majority prefers computerized tomographic (CT) imaging and favors interval appendectomy in appropriate candidates. Seventy percent indicate a stable child with suspected appendicitis would be operated on in a semiurgent manner rather than emergently in their practice. Discrepancy exists in the type and duration of antibiotic coverage, impact of clinical parameters on antibiotic use, and utility of discharge criteria. CONCLUSIONS: This study consolidates current opinions on appropriate management of pediatric appendicitis, providing a foundation for evidence-based outcome studies capable of bringing conformity to the management of this surgical disease. Such studies would establish clinical practice guidelines that optimize resource utilization while maintaining quality care.
Authors: Michael R Arnold; Blair A Wormer; Angela M Kao; David A Klima; Paul D Colavita; Graham H Cosper; Brant Todd Heniford; Andrew M Schulman Journal: Pediatr Surg Int Date: 2018-09-14 Impact factor: 1.827
Authors: Luis Angel Medina Andrade; Franz Yeudiel Pérez Muñoz; María Valeria Jiménez Báez; Stephanie Serrano Collazos; Maria de Los Angeles Martinez Ferretiz; Brenda Ruiz; Oscar Montes; Stephanie Woolf; Jessica Gonzalez Noriega; Uriel Maldonado Aparicio; Israel Gonzalez Gonzalez Journal: World J Surg Date: 2016-11 Impact factor: 3.352
Authors: Anupam B Kharbanda; Nanette C Dudley; Lalit Bajaj; Michelle D Stevenson; Charles G Macias; Manoj K Mittal; Richard G Bachur; Jonathan E Bennett; Kelly Sinclair; Craig Huang; Peter S Dayan Journal: Arch Pediatr Adolesc Med Date: 2012-08