Hernia 2007,11(1):41–45.PubMedCrossRef 18. Jin J, Rosen MJ, Blatnik J, McGee MF, Williams CP, Marks J, Ponsky J: Use of acellular dermal matrix for complicated ventral hernia repair: does technique affect outcomes? J Am Coll Surg 2007,205(5):654–660.PubMedCrossRef 19. Candage R, Jones K, Luchette FA, Sinacore JM, Vandevender

D, Reed RL 2nd: Use of human acellular dermal matrix for hernia repair: friend or foe? Surgery 2008,144(4):703–709.PubMedCrossRef 20. Butler CE: The role of bioprosthetics in abdominal wall reconstruction. Clin Plast Surg 2006,33(2):199–211.PubMedCrossRef 21. Ferrara R, Imperiale S, Polato R, Frena A, Martin F: Impianto di protesi biologica di collagene di derma porcino per laparocele complesso: caso clinico. Osp Ital Chir 2008,14(4):451–454. Competing interests All authors this website declare no conflict of interest. Authors’ contributions All authors participated to the meeting in Bergamo in order to elaborate the decisional model on biological prosthesis use in abdominal surgery, proposed in this article. FeCo and LA drafted the manuscript All authors read and approved the final manuscript.”
“Introduction Acute appendicitis (AA) is one of the most common abdominal emergencies. Although patients with AA often present

with a characteristic symptom complex and physical findings, atypical presentations are common. Missed PLX-4720 order or delayed diagnosis can lead to increased rates of perforation and morbidity [1]. The clinical diagnosis of AA is difficult, and management errors are frequent, with rates of negative explorations reaching 20% to 30% [2]. Despite the wide use of imaging techniques, appendicitis remains a challenging diagnosis [3]. Patients with suspected appendicitis are Oxaprozin mainly managed on the basis

of their disease history and physical examination; the value of laboratory examinations is controversial. Some works have assessed the diagnostic accuracy of different inflammatory markers in appendicitis with heterogeneous designs and results including: total white blood cells (WBCs), granulocytes, C-reactive protein, leukocyte elastase activity, D-lactate, phospholipase A2 and interleukine-6 [4–6]. Studies have shown inconsistent information regarding the use of WBCs count and differential in AA diagnosis. Although most studies show an association between elevated WBCs count in appendicitis diagnosis, its significance varies greatly [7–10]. Another question that has been raised is whether a normal WBCs count and differential can adequately rule out a diagnosis of appendicitis. There have been reports of high negative predictive values (NPVs >90%) for normal WBCs count and differential [7, 9]. The aim of this retrospective study was to assess diagnostic value of total WBCs and neutrophils counts in patients who underwent appendectomy due to suspicious of AA.