• Scott A Turner, Hee Soo Jung, and John E Scarborough.
• Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI. Electronic address: Sturner6@kumc.edu.
• Surgery. 2019 Jun 1; 165 (6): 1199-1202.

BackgroundTo determine whether utilization of a retrieval bag during laparoscopic appendectomy for uncomplicated and complicated appendicitis (perforation/abscess) is associated with postoperative surgical site infection rates.MethodsWe studied patients presented in the database of the 2016 Appendectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program who underwent laparoscopic appendectomy for pathology-confirmed appendicitis. The primary predictor variable was intraoperative utilization of a specimen retrieval bag for removal of the appendix from the peritoneal cavity. The primary outcome variable was 30-day postoperative surgical site infection. Logistic regression analysis was used to determine the association between use of a specimen retrieval bag and postoperative surgical site infection rate after adjustment for patient- and disease-related variables.ResultsA total of 10,357 patients were included for analysis. Of these procedures, 9,585 (92.6%) included the use of a specimen bag and 772 (7.5%) did not. The 30-day incidence of postoperative surgical site infection was 4.2% in the group in which no bag was used and 3.6% in the group in which a bag was used (adjusted odds ratio of surgical site infection with no bag utilization was 1.15 [95% confidence interval 0.78-1.69; P = .49]). The lack of a statistically significant association between bag utilization and postoperative surgical site infection incidence was also demonstrated for a subgroup of patients with perforated appendicitis.ConclusionUtilization of a retrieval bag during laparoscopic appendectomy is not associated with a statistically significant decrease in postoperative surgical site infection for either uncomplicated or complicated acute appendicitis.Copyright © 2019 Elsevier Inc. All rights reserved.

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