Evidence map›Paper›PMID 32075838›Full record

SynthesisBMJ open2020

Global incidence of surgical site infection after appendectomy: a systematic review and meta-analysis.

Celestin Danwang, Jean Joel Bigna, Joel Noutakdie Tochie, Aimé Mbonda, Clarence Mvalo Mbanga, Rolf Nyah Tuku Nzalie, Marc Leroy Guifo, Arthur Essomba

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07274878 (Simple Interrupted Skin Sutures Versus Subcuticular Suture Plus Subcutaneous Drain for Wound Outcomes After Open Appendectomy), which is not on this map. Cited by 48 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
48citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07274878 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

Simple Interrupted Skin Sutures Versus Subcuticular Suture Plus Subcutaneous Drain for Wound Outcomes After Open Appendectomy

TypeinterventionalSponsorAssiut UniversityRan2025 to 2027Enrolled100ConditionsSuturesArmssubcuticular suture plus subcutaneous drain
3 · Its place in the literature

Who cites it

48 citing papers in PubMed, 11 syntheses or guidelines pooled it.

  1. Pooled it
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  10. Global Incidence of Surgical Site Infection Among Patients: Systematic Review and Meta-Analysis.Inquiry : a journal of medical care organization, provision and financing
    Pooled it
  11. Incidence of Urinary Tract Infection Among Patients: Systematic Review and Meta-Analysis.Inquiry : a journal of medical care organization, provision and financing
    Pooled it
  12. Trial
  13. Trial
  14. Is it necessary to use specimen retrieval bag for reducing surgical site infection in laparoscopic appendectomy?A randomized controlled trial.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2023
    Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Celestin DanwangEpidemiology and Biostatistics Unit, Institute of Experimental and Clinical Research, Université Catholique de Louvain, Bruxelles, Belgium.ORCID 0000-0002-7976-4331
Jean Joel BignaDepartment of Epidemiology and Public Health, Centre Pasteur of Cameroon, Yaoundé, Cameroon bignarimjj@yahoo.fr.ORCID 0000-0001-8018-6279
Joel Noutakdie TochieDepartment of Anesthesiology and Critical Care Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.ORCID 0000-0002-8338-2467
Aimé MbondaDepartment of General Medicine, Djohong District Hospital, Djohong, Cameroon.
Clarence Mvalo MbangaDepartment of General Medicine, Mankon Sub-Divisional Hospital, Bamenda, North West Region, Cameroon.
Rolf Nyah Tuku NzalieDepartment of General Medicine, Ngong District Hospital, Ngong, North Region, Cameroon.
Marc Leroy GuifoDepartment of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
Arthur EssombaDepartment of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough surgical site infection (SSI) is one of the most studied healthcare-associated infections, the global burden of SSI after appendectomy remains unknown.

objectiveWe estimated the incidence of SSI after appendectomy at global and regional levels.

designSystematic review and meta-analysis.

participantsAppendectomy patients. DATA SOURCES: EMBASE, PubMed and Web of Science were searched, with no language restrictions, to identify observational studies and clinical trials published between 1 January 2000 and 30 December 2018 and reporting on the incidence of SSI after appendectomy. A random-effect model meta-analysis served to obtain the pooled incidence of SSI after appendectomy.

resultsIn total, 226 studies (729 434 participants from 49 countries) were included in the meta-analysis. With regard to methodological quality, 59 (26.1%) studies had low risk of bias, 147 (65.0%) had moderate risk of bias and 20 (8.8%) had high risk of bias. We found an overall incidence of SSI of 7.0 per 100 appendectomies (95% prediction interval: 1.0-17.6), varying from 0 to 37.4 per 100 appendectomies. A subgroup analysis to identify sources of heterogeneity showed that the incidence varied from 5.8 in Europe to 12.6 per 100 appendectomies in Africa (p<0.0001). The incidence of SSI after appendectomy increased when the level of income decreased, from 6.2 in high-income countries to 11.1 per 100 appendectomies in low-income countries (p=0.015). Open appendectomy (11.0 per 100 surgical procedures) was found to have a higher incidence of SSI compared with laparoscopy (4.6 per 100 appendectomies) (p=0.0002).

conclusionThis study suggests a high burden of SSI after appendectomy in some regions (especially Africa) and in low-income countries. Strategies are needed to implement and disseminate the WHO guidelines to decrease the burden of SSI after appendectomy in these regions. PROSPERO REGISTRATION NUMBER: CRD42017075257.

Indexed as

AppendectomySurgical Wound InfectionAfricaClinical Trials as TopicEuropeHumansIncidenceObservational Studies as Topicepidemiologyhealth policyPublic healthquality in health care

Identifiers

PMID32075838
PMCPMC7045165

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.