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Appendectomy Guidelines in the Philippines

The document discusses the surgical and post-operative management of acute appendicitis. It recommends open appendectomy as the primary treatment approach in the Philippines, as it results in shorter operation times and lower infection rates than laparoscopic appendectomy. Post-operatively, patients' input/output, vital signs, and pain levels should be monitored closely. Most patients do not require antibiotics beyond 24 hours after an uncomplicated appendectomy. Early ambulation and oral feeding are encouraged once bowel function returns to normal.

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Jeremae Bassig
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9 views2 pages

Appendectomy Guidelines in the Philippines

The document discusses the surgical and post-operative management of acute appendicitis. It recommends open appendectomy as the primary treatment approach in the Philippines, as it results in shorter operation times and lower infection rates than laparoscopic appendectomy. Post-operatively, patients' input/output, vital signs, and pain levels should be monitored closely. Most patients do not require antibiotics beyond 24 hours after an uncomplicated appendectomy. Early ambulation and oral feeding are encouraged once bowel function returns to normal.

Uploaded by

Jeremae Bassig
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

For the surgical management,

Appendectomy is the done as soon as possible to decrease risk of


perforation.

Open Appendectomy is the recommended primary approach to the


treatment of acute appendicitis in the Philippine setting.

It results in shorter operative times and lower intra-abdominal infection


rates.

An alternative to Open Appendectomy is Laparoscopic Appendectomy.

It is the standard of care outside the Philippines, especially in the US.

It is also done in supine position with the left arm tucked for better access.

Advantages include shorter length of stay, faster return to work and


lower superficial wound infection rates. While the Disadvantages are
longer duration of surgical procedure and high intra-abdominal infection
rates.

For the post-operative management,


We will monitor the input and output of the patient and note the urine
color and concentration every hour. Also, we will monitor the vital signs
every hour to identify if there is fluctuating intravascular volumes.

For the pain management,


Patient may be given Tramadol 50-100mg tab orally every 4-6 hours and
Paracetamol 500mg tab as needed for relief of fever.

Appendectomy is a relatively safe procedure with an extremely low


mortality rate. So it is less likely to develop intra-abdominal abscess.

Most patients do not require further antibiotics within 24h of surgery,


especially for patients with non-perforated appendicitis. While for
patients with perforated appendicitis will be treated with antibiotics for
3-7 days.

If there are no post-operative complications, the patient may be sent


home after 24 hours.

For the activity,


Early ambulation is encouraged to promote normalization of organ
function and to stimulate peristalsis, passage of flatus, reduction of
abdominal discomfort.

The patient may start early oral feeding as soon as the patient has
return of peristalsis such as normal bowel sounds, passage of flatus and
if fluid intake is tolerated well.

Lastly, educate patient regarding the proper wound care and hygiene
practices.

That’s all, thank you!

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