From
StayCurrentMD
Standardization of Care for Pediatric Perforated Appendicitis
With Dr. Todd Ponsky · hosted by Dr. Todd Ponsky
Part of
Appendicitis 29 items
Chapter 1 of 1 · Evidence & Research
Protocol standardization
Standardization of perforated appendicitis care improves outcomes
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
The way pediatric surgery is done is quite variable and not standardized, especially appendicitis.
The hospital had a clinical pathway in place for about 30 years before implementing a new pathway in 2015.
The new pathway initiated a disease severity classification for perforated appendicitis.
The new pathway refined discharge criteria for perforated appendicitis.
The new pathway standardized the operative technique for perforated appendicitis.
The new pathway established criteria for the use of postoperative TPN in perforated appendicitis.
The new pathway established criteria for the use of postoperative imaging in perforated appendicitis.
The new pathway established criteria for the use of postoperative invasive procedures such as draining an abscess.
The study prospectively evaluated outcomes of all children treated on the new standardized protocol over 20 months.
The study compared prospective outcomes to all patients treated in the 58 months prior to standardization.
Median follow-up time post-discharge was 14 days in the pre-standardized group.
Median follow-up time post-discharge was 25 days in the post-standardized group.
Standardization significantly reduced postoperative abscess in perforated appendicitis.
Standardization significantly reduced hospital stay in perforated appendicitis.
Standardization reduced the odds of developing a postoperative abscess by 4 times.