Importance of Peritoneal Free Fluid Cultures in Acute Appendicitis
Importance of Peritoneal Free Fluid Cultures in Acute Appendicitis
The purpose of this study is to evaluate the frequency of positive free fluid cultures in
 both perforated and non-perforated appendicitis. In addition predictors of positive free
 fluid cultures will be analyzed.
Prior to surgery, all patients will receive antibioprophylaxis. In case of free peritoneal
 fluid, a sample is aspirated and sent for microbiology. A lavage with saline is not
 necessary. The decision to start postoperative antibiotic is left at the discretion of the
 surgeon. The decision to leave an abdominal drain is left at the discretion of the surgeon.

 The use of a preoperative single dose administration of antibiotics has been extensively
 studied and found beneficial in the prevention of SSI in appendicitis. However, the use of
 continued postoperative antibiotics has barely been studied. The sparse evidence that exist
 does not seem to support its systematic use. During appendectomy the surgeon frequently
 encounters turbid free fluid, even in non-perforated appendicitis. It is common practice in
 Belgium to continue antibiotic prophylaxis for 5 days after aspiration and lavage. Although
 the aspect often seems purulent, it is unknown in what percentage this fluid is contaminated.
 Also, it is unknown whether after aspiration and lavage intra-abdominal drains are necessary.
Inclusion Criteria:

 -  Appendicitis (Perforated/ Non-perforated) Free fluid Age: 6 - 90y

 Exclusion Criteria:

 -  Immunosuppression (recent chemotherapy, chronic use of immunosuppressive medication)
 Age < 6 and > 90y