Implemented Interventions in Preventing Surgical Site Infection in Pediatric Appendicitis Patients: A Scoping Review

Abstract

Objective: Surgical site infections (SSIs), especially deep/organ-space SSIs, are common and serious complications following appendectomy. This review aimed to explore the interventions that have been implemented to reduce the risk of SSIs in pediatric appendicitis patients. Methods: A literature search was performed using PubMed, Cochrane, and Embase databases of studies in English published between January 01, 1973, and April 30, 2023. Studies on pediatric patients (≤ 18 years) with appendicitis that described any interventions aimed at reducing SSIs and reported SSIs as an outcome were included. Results: A total of 56 studies were included in the final scoping review. The interventions included antibiotic stewardship, clinical practice guidelines/pathways, different surgical approaches, timing of appendectomy, irrigation or lavage, use of peritoneal drains, timing of wound closure and management, parenteral nutrition, pain management, and outpatient management. Conclusion: A wide variety of interventions have been studied in pediatric appendicitis patients to reduce the SSI rates. Very few publications have studied low-cost, widely available intraoperative interventions to reduce deep/organ-space SSIs.