Trial reportBMC surgery2025
Role of intraoperative antibiotics wound irrigation in reducing surgical site infection following open appendectomy: a randomized controlled trial.
Trial report in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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5 authors.
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Abstract
backgroundSurgical site infection (SSI) is a common complication following open appendectomy, particularly in low and middle income countries. Intraoperative wound irrigation with antibiotic solutions has been used as a preventive strategy, though its efficacy remains debated.
objectiveTo evaluate the effectiveness of intraoperative wound irrigation using a combination of ceftriaxone and metronidazole in reducing SSIs after open appendectomy, compared to normal saline irrigation.
methodsA double-blind randomized controlled trial was conducted between July 2023 and December 2024 at Abu Ghraib General Hospital. A total of 410 patients aged 15-50 years with acute appendicitis undergoing open appendectomy were randomized into two groups. The experimental group received layer by layer irrigation with ceftriaxone and metronidazole, while the control group received saline irrigation. Postoperative follow-up was conducted on days 10, 15, and 30 to assess the incidence of SSIs using CDC criteria.
resultsThere was no statistically significant difference in SSI rates between the experimental and control groups (4.1% vs. 6.6%; p = 0.278). Among patients with perforated appendices, SSI rates remained statistically insignificant between the two groups. Preoperative CRP and WBC levels were significantly higher in patients who developed SSIs (p < 0.0001). No significant difference was observed in hospital stay duration between the groups.
conclusionIntraoperative wound irrigation with ceftriaxone and metronidazole did not significantly reduce SSI incidence compared to saline irrigation in open appendectomy. Routine use of antibiotic irrigation may not be justified.
trial registrationThe study was retrospectively registered with the International Standard Randomised Controlled Trial Number (ISRCTN) registry under the registration number ISRCTN19878512 on 19 May 2025.
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