Wound and intraperitoneal infection following appendicectomy for perforated or gangrenous appendicitis.

A series of 158 children, who were operated on for perforated or gangrenous appendicitis between 1980 and 1984 inclusive, are reviewed. A protocol of management, based on the results of bacteriology of the perforated appendix was introduced and the guidelines followed in all but four instances. Eight patients (5.0%) developed postoperative infections, either in the wound or intraperitoneally. The frequency of infection was affected by the adherence to protocol, as 50% of the infections occurred in patients who did not receive preoperative antibiotic prophylaxis. The use of drainage also contributed to the frequency of wound infection. Thorough peritoneal lavage and meticulous surgical technique should reduce the need for drainage.