Post-appendectomy wound infection, a solved problem?

Over a 3.5 year period, 550 patients underwent an emergency operation under the diagnosis of acute appendicitis. The appendix proved to be normal in 82 patients, the other 468 patients had signs of acute inflammation with perforation in 142 cases. Management followed a strict protocol with single dose metronidazole as preoperative antibiotic prophylaxis and liberal open wound treatment in case of gross contamination. Consequently, the subcutaneous tissues and the skin were left open in 218 patients. The overall wound infection rate (1.3%) and the intra-abdominal abscess rate (1.1%) were extremely low. Open wound treatment was well accepted by the patients, did not prolong the hospital stay and gave good cosmetic results.