Appendicular Stump Disinfection Using Povidone- iodine Swab Compared with Electrocautery; which one is more effective?
Keywords:
Appendix, Povidone-Iodine, Electro coagulation, DisinfectionAbstract
Objective: To evaluate the effectiveness of povidine-iodine swab versus electrocautery to disinfect appendicular stump.
Methods: A randomized controlled trial was conducted in Services Institute of Medical Sciences, Lahore, with a sample size of 40 patients from 1st Dec 2012 to 31th August 2013. Random allocation was done into two equal groups. After cutting appendix, a culture swab was taken from the appendix stump. Electrocautery was used to disinfect appendicular stump in group A while, 10% povidone-iodine was used in group B. A second culture swab was taken from stump after five minutes. Absence of growth on the second culture was considered as effective therapy.
Results: Out of total 40 patients, 27 (67%) were males and 13 (33%) were females. Mean age of the patients was 25.6 years. Electrocautery was effective in 100% while Povidone-Iodine was effective in 60% cases (p<0.05). Wound infections were reported in 15% of the cases in electrocautery group and 20% in povidone-iodine group. While assessing possible relationship between wound infection and effective appendix stump disinfection. Out of 32 (20 in Group A and 12 in Group B) cases who were “effectively treated” as shown by negative culture reports after application of either intervention (cautery/ povidone-iodine), 4 (12%) cases developed wound infection. Whereas 3 out of 8 (All in Group B) (37%) patients in ‘In effectively treated’ group developed wound infection. Relationship between effectiveness of the treatment and wound infection could not reach to a statistically significance level. (p = 0.096)
Conclusion: Electrocautery is better option in disinfecting appendix stump as compared to Povidone-Iodine swab.
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