The prevention of infection in appendicectomy wounds

Abstract Fifty cases of acute appendicitis were examined at operation for the presence of free organisms on or around the appendix in situ, and for bacterial contamination of the wounds after removal of the appendix. Fifty-four per cent had free organisms around the appendix, 40 per cent of the wounds probably became contaminated, and 18 per cent became clinically infected. The operative technique was modified in 50 cases to minimize the chance of contaminating the wounds. There were 2 infections (4 per cent). In another series in which the usual operative technique was used the wounds were irrigated with tetracycline solution; there was 1 infection in 50 cases, an incidence of 2 per cent. In a similar trial the use of a mixture of powdered antibiotics in 50 cases did not influence the wound infection rate which remained at 18 per cent. The use of tetracycline solution and care in avoiding contamination of the wound are recommended.