Indexing Title: RDELEON’s Medical Anecdotal Report [04-1]

MAR Title: No Oral Antibiotics in an S/P Appendectomy

Date of Medical Observation: April 12, 2004

Narration:

I had an appendectomy to a 39/M and a C/O from the medical records section. Intraoperative finding was perforative appendicitis with generalized peritonitis. The patient was initially given IV antibiotics (Ampicillin, Gentamycin and Metronidazole) to about 2 day dose. The incision site was left open as part of our protocol. The patient was subsequently discharged with proper advised. Knowing that the patient had a complicated appendectomy I advise patient to follow up after a week but to my surprise the patient didn’t had his follow up as instructed. So I asked the personnel from the medical records to advise the patient to have a follow up with me. And the patient did. As I was checking the patient incision site, the patient told me that he wasn’t able to get a prescription of his oral medication, no oral antibiotic was taken since the day he was discharge. So I was expecting to see the incision site to be infected or something, but as I was cleaning up the wound, I saw that the wound was granulating and was opposing very well with no signs of infection, and it was really a good wound healing. The patient told me that what he did was to wash the wound 3x a day as I advised.

Insights (Discovery, Stimulus, REINFORCEMENT):

First, we can say that wound dressing and cleaning is still superior to oral antibiotics. And proper daily wound helps a lot in wound healing. That as a physician, it is very important that patient (whether complicated or uncomplicated case) should to be advised to h