Tovar J A
An Esp Pediatr. 1980 Jun;13(6):513-22.
The high incidence and severity of suppurative complications consecutive to appendiceal rupture in children can justify this review. Mixed colonic flora, with a predominance of "E. coli" among and "B. fragilis" among anaerobes, is constantly recovered from the original purulent exudate as well as from that of suppurative complications. It seems therefore wise to complete surgical treatment with an adequate early antibiotic association direction to the particular flora. Gentamycin and Clindamycin seem to fulfill satisfactorily these requirement. On the contrary, peritoneal irrigation either with antiseptic or antibiotic fluids seems to be practically useless, and so are drains exept when they are inserted to evacuate a localized purulent collection Delayed closure of the contaminated wound can be an additional factor in the prevention of suppurative complications.
儿童阑尾破裂后化脓性并发症的高发生率和严重性足以说明此次综述的合理性。从最初的脓性渗出物以及化脓性并发症的渗出物中，经常能分离出混合性结肠菌群，其中需氧菌以“大肠杆菌”为主，厌氧菌以“脆弱拟杆菌”为主。因此，在手术治疗的基础上，早期给予针对特定菌群的适当抗生素联合治疗似乎是明智的。庆大霉素和克林霉素似乎能很好地满足这些要求。相反，用防腐液或抗生素液进行腹腔灌洗似乎实际上并无用处，引流管也是如此，除非是为了引出局部脓性积液而插入。污染伤口的延迟缝合可能是预防化脓性并发症的一个额外因素。
