The Relationship of Delayed Appendectomy to the Incidence of Surgical Site Infection (SSI) in Acute Appendicitis Patients: a Narrative Review

Abstract

Acute appendicitis is one of the most common causes of surgery worldwide. Appendectomy is a skeptical surgical intervention associated with the risk of Surgical Site Infection (SSI). The purpose of this analysis was to describe the relationship between delayed appendectomy in acute appendicitis and the incidence of SSI. Reviewers selected articles containing data on the incidence of SSI due to appendectomy delays for 3 to 48 hours from seven databases, namely Pubmed, Nature, SpringerLink, Science Direct, ProQuest, Oxford Open Access Journal, and Cochrane Library. The data source was secondary data from international articles published in 2011 to 2020 based on the PICO criteria. The data obtained were then grouped and synthesized without meta-analysis/Synthesis Without Metaanalysis (SWiM) descriptively. A total of 2,778 articles were collected, of which 24 studies met the inclusion criteria. A total of 4 articles showed an association between appendectomy delay and SSI while the other 20 articles did not show a relationship between the two. There was no relationship between appendectomy delays for less than 48 hours since hospital admission to surgery with the incidence of SSI, however a delayed for more than 48 hours showed a significant value. The results showed there was no relationship between delayed appendectomy for less than 48 hours since the time the patient was admitted to the hospital until the surgery took place, but a delayed appendectomy delay for more than 48 hours showed a significant relationship with the incidence of SSI. This narrative review supports early surgical intervention of acute appendicitis cases by considering the severity of the patient to avoid other surgical complications.