{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T20:46:45Z","timestamp":1785012405820,"version":"3.55.0"},"reference-count":31,"publisher":"BMJ","issue":"6255","license":[{"start":{"date-parts":[[1980,12,13]],"date-time":"1980-12-13T00:00:00Z","timestamp":345513600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br Med J"],"published-print":{"date-parts":[[1980,12,13]]},"abstract":"<jats:p>Two hundred and eighty questionnaires were sent to junior surgical staff throughout England inquiring about their use of systemic antibiotic prophylaxis, topical antibacterial agents, and surgical drainage in appendicectomy. One hundred and seventy-five (63%) replies were received from 81 of the 87 hospitals included in the survey. Prophylactic systemic antibiotics were used by 78 surgeons (46%) when operating on a normal appendix but by 168 (99%) when the organ had perforated. Most surgeons started antibiotics before operation, but proportionately fewer did so when the appendix was gangrenous or perforated. Patients with severe contamination tended to receive longer courses of antibiotics, although the duration of administration varied considerably. Metronidazole was included in over 95% of all the prophylactic regimens and was often combined with other drugs when the appendix was gangrenous and perforated. Topical antibacterial agents were applied to the wound routinely by only 45 surgeons (26%), although 106 (61%) used them sometimes. Povidone-iodine was the agent most commonly used. Only 98 surgeons (56%) ever drained appendicectomy wounds, while 135 (77%) sometimes drained the peritoneal cavity. Evidence suggests that present methods of giving systemic antibiotic prophylaxis should continue, but that topical agents and surgical drainage are perhaps unnecessary when surgeons are confident of the efficacy of the systemic treatment used.<\/jats:p>","DOI":"10.1136\/bmj.281.6255.1597","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T18:32:30Z","timestamp":1238697150000},"page":"1597-1600","source":"Crossref","is-referenced-by-count":22,"title":["Prophylaxis of infection after appendicectomy: a survey of current surgical practice."],"prefix":"10.1136","volume":"281","author":[{"given":"W B","family":"Campbell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1980,12,13]]},"reference":[{"key":"ref_1","first-page":"79","article-title":"The value and duration of defence reactions of the skin to the primary lodgement of bacteria. BrJ'","volume":"38","author":"Miles, A.A.; Miles, E.M.; Burke, J.","year":"1957","unstructured":"Miles AA, Miles EM, Burke J. The value and duration of defence reactions of the skin to the primary lodgement of bacteria. BrJ' Exp Pathol 1957; 38:79-96.","journal-title":"Exp Pathol"},{"issue":"50","key":"ref_2","first-page":"161","article-title":"The effective period of preventive antibiotic action in experimental incisions and dermal lesions","volume":"1961","author":"Burke, J.F.","unstructured":"Burke JF. The effective period of preventive antibiotic action in experimental incisions and dermal lesions. Surgery 1961;50:161-8.","journal-title":"Surgery"},{"key":"ref_3","first-page":"179","article-title":"Peritoneal drainage and systemic antibiotics after appendicectomy","volume":"ii:","author":"Magarey, C.J.; Chant, A.D.B.; Rickford, C.R.K.; Magarey, JR","year":"1971","unstructured":"Magarey CJ, Chant ADB, Rickford CRK, Magarey JR. Peritoneal drainage and systemic antibiotics after appendicectomy. Lancet 1971;ii: 179-82.","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/0002-9610(78)90100-9","article-title":"Acute appendicitis: efficacy of prophylactic preoperative antibiotics in the reduction of septic morbidity","volume":"135","author":"Fine, M.; Busuttil, R.W.","year":"1978","unstructured":"Fine M, Busuttil RW. Acute appendicitis: efficacy of prophylactic preoperative antibiotics in the reduction of septic morbidity. Am J Surg 1978;135:210-2.","journal-title":"Am J Surg"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1136\/jcp.27.12.997","article-title":"Bacterial flora of the appendix fossa in appendicitis and postoperative wound infection","volume":"27","author":"Leigh, D.A.; Simmons, K.; Norman, E.","year":"1974","unstructured":"Leigh DA, Simmons K, Norman E. Bacterial flora of the appendix fossa in appendicitis and postoperative wound infection. J Clin Pathol 1974; 27:997-1000.","journal-title":"J Clin Pathol"},{"issue":"10","key":"ref_6","first-page":"517","article-title":"Archive de Medicine Experimentale et d'Anatomie","volume":"1898","author":"Veillon, A.; Zuber, A.","unstructured":"Veillon A, Zuber A. Archive de Medicine Experimentale et d'Anatomie Pathologique 1898;10:517.","journal-title":"Pathologique"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1093\/jac\/4.suppl_C.15","article-title":"Cited by Willis et al.11 7Leigh DA. Indications for antibiotic prophylaxis and treatment in patients undergoing appendicectomy","volume":"4","year":"1978","unstructured":"Cited by Willis et al.11 7Leigh DA. Indications for antibiotic prophylaxis and treatment in patients undergoing appendicectomy. 7 Antimicrob Chemother 1978;4:15-23.","journal-title":"7 Antimicrob Chemother"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/bjs.1800510505","article-title":"Appendicectomy wound infection, drainage, and antibiotics","volume":"51","author":"Vinnicombe, J.","year":"1964","unstructured":"Vinnicombe J. Appendicectomy wound infection, drainage, and antibiotics. BrJ Surg 1964;51:328-31.","journal-title":"BrJ Surg"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1002\/bjs.1800660317","article-title":"One-dose antibiotic prophylaxis against wound infection after appendicectomy: a randomized trial of clindamycin, cefazolin sodium, and a placebo","volume":"66","author":"Donovan, I.A.; Ellis, D.; Gatehouse, D.","year":"1979","unstructured":"Donovan IA, Ellis D, Gatehouse D, et al. One-dose antibiotic prophylaxis against wound infection after appendicectomy: a randomized trial of clindamycin, cefazolin sodium, and a placebo. BrJ Surg 1979;66:193-6.","journal-title":"BrJ Surg"},{"key":"ref_10","first-page":"973","article-title":"Prophylactic lincomycin in the prevention of wound infection following appendicectomy: a double blind study. BrJ'","volume":"63","author":"Leigh, D.A.; Pease, R.; Henderson, H.; Simmons, K.; Russ, R.","year":"1976","unstructured":"Leigh DA, Pease R, Henderson H, Simmons K, Russ R. Prophylactic lincomycin in the prevention of wound infection following appendicectomy: a double blind study. BrJ' Surg 1976;63:973-7.","journal-title":"Surg"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1136\/bmj.1.6005.318","article-title":"Metronidazole in prevention and treatment of bacteroides infections after appendicectomy","volume":"i:","author":"Willis, A.T.; Ferguson, I.R.; Jones, P.H.","year":"1976","unstructured":"Willis AT, Ferguson IR, Jones PH, et al. Metronidazole in prevention and treatment of bacteroides infections after appendicectomy. Br Med J 1976;i:318-21.","journal-title":"Br Med J"},{"key":"ref_12","first-page":"547","article-title":"Prophylactic metronidazole in appendicectomy: a controlled trial","volume":"76","author":"Bates, T.; Touquet, V.L.R.; Tutton, M.K.; Mahmoud, S.E.; Reuther, J.W.A.","year":"1980","unstructured":"Bates T, Touquet VLR, Tutton MK, Mahmoud SE, Reuther JWA. Prophylactic metronidazole in appendicectomy: a controlled trial. Br J Surg 1980;76:547-50.","journal-title":"Br J Surg"},{"key":"ref_13","first-page":"275","article-title":"Rational use of antibiotic therapy after appendicectomy. Br MedJ3","volume":"280","author":"Pinto, D.J.; Sanderson, P.J.","year":"1980","unstructured":"Pinto DJ, Sanderson PJ. Rational use of antibiotic therapy after appendicectomy. Br MedJ3 1980;280:275-7."},{"key":"ref_14","first-page":"115","article-title":"The prevention of wound infection after appendicectomy. Antisepsis or chemotherapy?","volume-title":"Royal Society of Medicine international congress and symposium series 1979; No","volume":"18","author":"Salem, R.","unstructured":"Salem R. The prevention of wound infection after appendicectomy. Antisepsis or chemotherapy? Royal Society of Medicine international congress and symposium series 1979; No 18:115-7."},{"key":"ref_15","first-page":"469","article-title":"Single-dose antibiotic prophylaxis in appendicectomy","volume":"143","author":"Ivarsson, L.E.","year":"1977","unstructured":"Ivarsson LE. Single-dose antibiotic prophylaxis in appendicectomy. Acta Chir Scand 1977;143:469-72.","journal-title":"Acta Chir Scand"},{"key":"ref_16","first-page":"151","article-title":"The prophylaxis of surgical infection: the effect of prophylactic antimicrobial drugs on the incidence of infection following potentially contaminated operations","volume":"56","author":"Bernard, H.R.; Cole, W.R.","year":"1964","unstructured":"Bernard HR, Cole WR. The prophylaxis of surgical infection: the effect of prophylactic antimicrobial drugs on the incidence of infection following potentially contaminated operations. Surgery 1964;56:151-7.","journal-title":"Surgery"},{"issue":"66","key":"ref_17","first-page":"97","article-title":"Postoperative wound infection: a prospective study of determinant factors and prevention","volume":"1969","author":"Polk, H.C.; Lopez-Mayor, J.F.","unstructured":"Polk HC, Lopez-Mayor JF. Postoperative wound infection: a prospective study of determinant factors and prevention. Surgery 1969;66:97-103.","journal-title":"Surgery"},{"key":"ref_18","first-page":"220","article-title":"Prevention of wound infection after appendicectomy","volume":"i:","author":"Gilmore, O.J.A.; Martin, T.D.M.; Fletcher, B.N.","year":"1973","unstructured":"Gilmore OJA, Martin TDM, Fletcher BN. Prevention of wound infection after appendicectomy. Lancet 1973;i:220-2.","journal-title":"Lancet"},{"key":"ref_19","first-page":"281","article-title":"Aetiology and prevention of wound infection in appendicectomy. BrJ'","volume":"61","author":"Gilmore, O.J.A.; Martin, T.D.M.","year":"1974","unstructured":"Gilmore OJA, Martin TDM. Aetiology and prevention of wound infection in appendicectomy. BrJ' Surg 1974;61:281-7.","journal-title":"Surg"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1002\/bjs.1800580209","article-title":"The prevention of infection in appendicectomy wounds","volume":"58","author":"Longland, C.J.; Gray, J.G.; Lees, W.; Garrett, J.A.M.","year":"1971","unstructured":"Longland CJ, Gray JG, Lees W, Garrett JAM. The prevention of infection in appendicectomy wounds. BrJ Surg 1971;58:117-9.","journal-title":"BrJ Surg"},{"key":"ref_21","first-page":"206","article-title":"Topical ampicillin in the appendicectomy wound: report of a double-blind trial. Br MedJ'","volume":"iv:","author":"Rickett, J.W.S.; Jackson, B.T.","year":"1969","unstructured":"Rickett JWS, Jackson BT. Topical ampicillin in the appendicectomy wound: report of a double-blind trial. Br MedJ' 1969;iv:206-7."},{"key":"ref_22","first-page":"111","article-title":"Topical ampicillin in grid-iron appendicectomy wounds","volume":"24","author":"Mountain, J.C.; Seal, P.V.","year":"1970","unstructured":"Mountain JC, Seal PV. Topical ampicillin in grid-iron appendicectomy wounds. BrJ Clin Pract 1970;24:111-5.","journal-title":"BrJ Clin Pract"},{"key":"ref_23","first-page":"531","article-title":"Wound infections after appendicectomy. I. A controlled trial on the prophylactic efficacy of topical ampicillin in non-perforated appendicitis. II. A controlled trial on the efficacy of delayed primary suture and topical ampicillin in perforated appendicitis","volume":"138","author":"Andersen, B.; Bendtsen, A.; Holbraad, L.; Schantz, A.","year":"1972","unstructured":"Andersen B, Bendtsen A, Holbraad L, Schantz A. Wound infections after appendicectomy. I. A controlled trial on the prophylactic efficacy of topical ampicillin in non-perforated appendicitis. II. A controlled trial on the efficacy of delayed primary suture and topical ampicillin in perforated appendicitis. Acta Chir Scand 1972;138:531-6.","journal-title":"Acta Chir Scand"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1002\/bjs.1800580611","article-title":"Topical noxythioline antisepsis. Report of a controlled trial","volume":"58","author":"Bird, G.G.; Bunch, G.A.; Croft, C.B.","year":"1971","unstructured":"Bird GG, Bunch GA, Croft CB, et al. Topical noxythioline antisepsis. Report of a controlled trial. BrJ Surg 1971;58:447-8.","journal-title":"BrJ Surg"},{"key":"ref_25","first-page":"121","article-title":"Prevention of wound infections after appendicectomy. A trial of two procedures","volume":"19","author":"Fraser-Moodie, A.","year":"1974","unstructured":"Fraser-Moodie A. Prevention of wound infections after appendicectomy. A trial of two procedures. J R Coll Surg Edinb 1974;19:121-3.","journal-title":"J R Coll Surg Edinb"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1002\/bjs.1800630821","article-title":"Bacteriological survey of acute appendicitis in children","volume":"63","author":"Lari, J.; Kirk, D.; Howden, R.","year":"1976","unstructured":"Lari J, Kirk D, Howden R. Bacteriological survey of acute appendicitis in children. BrJ Surg 1976;63:643-6.","journal-title":"BrJ Surg"},{"key":"ref_27","article-title":"Management of appendicitis","author":"Everson, N.W.; Nash, JR","year":"1976","unstructured":"Everson NW, Nash JR. Management of appendicitis. Br Med J 1976; ii:1390.","journal-title":"Br Med J"},{"key":"ref_28","year":"1980","unstructured":"(Accepted 1 7 October 1980)"},{"key":"ref_29","article-title":"Case histories Case 1-A 33-year-old man presented in 1973 with a painless nodule in the left lobe of the thyroid. He was euthyroid and otherwise fit. At operation a papillary carcinoma in the left lobe of the thyroid and an enlarged retroclavicular lymph node containing carcinoma were removed. He was subsequently treated with 131I and remained well with no recurrence","unstructured":"Case histories Case 1-A 33-year-old man presented in 1973 with a painless nodule in the left lobe of the thyroid. He was euthyroid and otherwise fit. At operation a papillary carcinoma in the left lobe of the thyroid and an enlarged retroclavicular lymph node containing carcinoma were removed. He was subsequently treated with 131I and remained well with no recurrence."},{"key":"ref_30","article-title":"Case 2-A younger brother of case 1 was 38 when in 1979 he noticed a nodule in the left lobe of the thyroid. He was euthyroid and otherwise well. At operation a papillary carcinoma was found without evidence of spread beyond the thyroid. Near-total thyroidectomy was carried out followed by 1311 treatment. He remained well without recurrence","unstructured":"Case 2-A younger brother of case 1 was 38 when in 1979 he noticed a nodule in the left lobe of the thyroid. He was euthyroid and otherwise well. At operation a papillary carcinoma was found without evidence of spread beyond the thyroid. Near-total thyroidectomy was carried out followed by 1311 treatment. He remained well without recurrence."},{"key":"ref_31","first-page":"3","article-title":"The association of radiation with the development of thyroid cancer, often some 20-30 years later, is well recognised, though the dose has usually been in the range 2-5 Gy","volume-title":"An increased incidence of cancer may, however, occur after much lower doses","year":"(200-300","unstructured":"The association of radiation with the development of thyroid cancer, often some 20-30 years later, is well recognised, though the dose has usually been in the range 2-5 Gy (200-300 rads).3 An increased incidence of cancer may, however, occur after much lower doses, and"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.281.6255.1597","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.281.6255.1597","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T14:46:17Z","timestamp":1765464377000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.281.6255.1597"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1980,12,13]]},"references-count":31,"journal-issue":{"issue":"6255","published-online":{"date-parts":[[1980,12,13]]},"published-print":{"date-parts":[[1980,12,13]]}},"alternative-id":["10.1136\/bmj.281.6255.1597"],"URL":"https:\/\/doi.org\/10.1136\/bmj.281.6255.1597","relation":{},"ISSN":["0007-1447","1468-5833"],"issn-type":[{"value":"0007-1447","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1980,12,13]]}}}