Is abandoning routine peritoneal cultures during appendectomy justified?

OBJECTIVE: To identify if there are any advantages of taking swab from the peritoneal fluid during appendectomy, and if it has any clinical implication on the progress of diseases.

METHODS: Records of 160 patients who underwent appendectomy in Saqr Hospital, Rak, United Arab Emirates, from 2003 - 2005, and had culture and sensitivity from the peritoneal cavity were reviewed retrospectively. The macroscopic picture of the appendix, microorganism in peritoneal cultures, antibiotic, and the extent of using the result of the culture and sensitivity were evaluated. Patients with normal appendix who underwent laparoscopic appendectomy were excluded.

RESULTS: Patients age ranged from 4-55 years with male to female ratio of 4:1, all had prophylactic antibiotics and standard surgical procedures; 60% had perforated appendix, 13% were gangrenous. The most common organisms cultured were, Escherichia coli and bacteroids, rate of wound infection was 5%. None of the patients had their course of antibiotics adjusted in response to the result of the swab.

CONCLUSION: Swabs from the peritoneal cavity during appendectomy do not have any clinical advantage especially with the empiric use of antibiotics and the short hospital stay.