title: Simple acute appendicitis versus non-perforated gangrenous appendicitis: is there a difference in the rate of post-operative infectious complications?
abstract: BACKGROUND
  According to the 2002 Surgical Infection Society Guidelines on Antimicrobial Therapy for Intra-abdominal Infections, antimicrobial therapy is not recommended beyond 24 hours for the treatment of postoperative acute or gangrenous appendicitis without perforation. However, clinicians commonly consider gangrenous appendicitis to pose a greater risk of post-operative infectious complications, such as surgical site infections and intra-abdominal abscesses. This study examines the relative risk of post-operative infection between patients with simple and gangrenous appendicitis.
  
  
  METHODS
  A retrospective review of patients with either non-perforated gangrenous or simple appendicitis from 2010 to 2012 was performed at a large urban teaching hospital.
  
  
  RESULTS
  The rate of post-operative intra-abdominal abscess formation, which was diagnosed on patient readmission to the hospital, was significantly greater in patients with non-perforated gangrenous appendicitis in comparison to those with simple non-perforated appendicitis. Also, patients with non-perforated gangrenous appendicitis received extended courses of post-operative antibiotics, despite SIS recommendations.
  
  
  CONCLUSIONS
  The role of peri-operative antibiotics for non-perforated gangrenous appendicitis merits further study.
authors.affiliation: Daughtry Family Department of Medicine, University of Miami/Miller School of Medicine , Miami, Florida.
authors.forename: Andrea
authors.initials: A
authors.lastname: Romano
authors.forename: Punam
authors.initials: P
authors.lastname: Parikh
authors.forename: Patricia
authors.initials: P
authors.lastname: Byers
authors.forename: Nicholas
authors.initials: N
authors.lastname: Namias
mesh_terms: D018784:Abdominal Abscess / Q000382:microbiology; D000208:Acute Disease; D000328:Adult; D001062:Appendectomy / Q000009:adverse effects*; D001064:Appendicitis / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005734:Gangrene / Q000382:microbiology; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000382:microbiology*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology* / Q000382:microbiology