PROSPECTIVE STUDY OF SURGICAL SITE INFECTION IN LAPAROSCOPIC APPENDECTOMY VS LAPAROSCOPIC CONVERTED INTO OPEN VS OPEN APPENDECTOMY

Background: Previous literature comparing the results of open appendectomy with laparoscopic appendectomy have yielded conflicting results. The present study aimed to determine the surgical site infection in patients undergoing laparoscopic appendectomy, open appendectomy and laparoscopic converted into open appendectomy and to assess the factors associated with surgical site infections among such patients. Methodology: The study was conducted as an observational study on patients who underwent appendectomy for acute appendicitis at tertiary care center during 18 months period. All the surgeries were performed by single senior experienced surgeon. Decision regarding type of surgery performed was decided by operating surgeon based upon condition of patient. Patients were assessed for presence of SSI and their risk factors. Results: A total of 88 patients were enrolled, of them 44 cases underwent open surgery whereas 27 cases underwent laparoscopic and 17 cases underwent Lap converted to open. Deep surgical site infection was observed in 6.8% and 6.7% cases in open appendectomy group and laparoscopy converted to open group respectively. Maximum patients (>95%) had no surgical site infection in laparoscopic appendectomy group. The incidence of surgical site infection was observed to be higher in open appendectomy and laparoscopy converted to open group as compared to laparoscopy group but the difference was statistically insignificant (p>0.05) Irrespective of type of surgery, independent factors associated with risk of surgical site infection were evaluated. Among various factors CRP was most independent predictor of surgical site infections (p<0.05). Conclusions: The risk of surgical site infections was higher in laparoscopic converted to open surgery and open appendectomy as compared to laparoscopic surgeries. Surgical site infection is associated with superficial and deep infections as well as organ space infections. Irrespective of type of surgery, independent factors associated with risk of surgical site infection were evaluated. Among various factors CRP was most independent predictor of surgical site infections