Authors (including presenting author) :
Choy YK (1), Chan Y (1), Chiu KM (1), Lee PY, Lee SK (1), Lau WY (1), Lun PY (1), Ng YKS (1), Chan WC (1)
Affiliation :
(1) Department of Surgery, North District Hospital
Introduction :
Surgery (Appendectomy) is the most effective treatment for patients who were diagnosed acute appendicitis. The surgical site infection (SSI) is the common complications after appendectomy. It is associated with increased morbidity, mortality, length of stay and decreased patients’ quality of life. In the second trimester of 2018, the SSI rate of patients who have undergone appendectomy in North District Hospital was 60% which was much higher than the Hospital Authority average SSI rate of appendectomy in 2017 (12.593%). According to the World Health Organization recommendations, it is good clinical practice for patients to bath before surgery to reduce SSI, so the Peri- operative body cleansing program for acute appendicitis patient was introduced in the late third trimester.
Objectives :
The peri-operative body cleansing program for acute appendicitis patients aim at getting rid of SSI after appendectomy.
Methodology :
This program targeted on patients who were diagnosed appendicitis and emergency operation for appendectomy were arranged. It is not feasible for acute appendicitis patients to get bath because of the poor general condition and limited time before surgery. Hence, 2% chlorhexidine gluconate (CHG) cloths for body cleansing and instruction were provided to patients when the emergency operation was offered. Most SSI is endogenous, and the source of bacteria is the patient’s own flora from the skin. The bacteria may invade from incisional site into the body. So, the body cleansing was mainly focused on Abdominal region. And It was carried out by patients, their relatives or nursing staff before surgery.
Result & Outcome :
The data was retrieved retrospectively. 16 cases who have undergone appendectomy were identified after implemented the program in 2018. 5 cases were randomly selected for survey. Only 1 case was found SSI after the surgery. Conclusion: The SSI rate of appendectomy was 20% after implemented the program in 2018. Although it was still higher than HA average SSI rate, it had significant dropped from 60% to 20% after the program started. The Peri-operative body cleansing program for acute appendicitis patients is effective in reducing the surgical site infection.
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