Прогнозирование вероятности инфекций области хирургического вмешательства при остром аппендиците

2013 
The purpose to suggest the way of the forecasting of surgical site infections (SSI) in case of appendectomy. Materials and methods There were formed 2 groups of patients: the main group included 517 patients, who were operated in 2009-2012. These patients received antibiotic prophylaxis with cefazolin, ceftriaxone, ampicillin/sulbactam. The control group consisted of 359 patients with acute appendicitis, who underwent treatment in 1999-2000. This group of patients did not have antibiotic prophylaxis, but antibiotic therapy in the post-operative period. E.V. Gubler’s methodology, based on Bayes’ formula, was used to reveal the most significant factors which influence the appearance of SSI. Results Multidimensional statistical analysis in the groups under investigation proved that the following signs correlate with the frequency of the development of SSI: patient’s age, time of admission from the beginning of the disease, clinical-morphological form of acute appendicitis, intraperitoneal complications, type of surgical intervention, risk index by NNIS, comorbidity (endocrine system diseases, disorders of nutrition and metabolism), leukocytosis at the admission, levels of indices of endogenic intoxication on the 1st day of operation, the presence of antibiotic prophylaxis. The created information table provides the possibility of 94,2 % for the forecasting of the development of SSI in case of acute appendicitis. The conclusion The created information table provides the possibility of 94,2 % for the forecasting of the development of SSI in case of acute appendicitis. This helps to prove the expediency of antibacterial therapy in the early post-operative period.
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