Background: Acute appendicitis is the most common surgical emergency in children, yet timely and accurate diagnosis remains challenging due to nonspecific clinical presentations and limitations of imaging and blood tests. Saliva has emerged as a promising diagnostic medium because it is non-invasive, painless, inexpensive, and highly acceptable for pediatric patients. Salivary biomarkers may provide rapid and child-friendly adjuncts to existing diagnostic pathways. Methods: A systematic literature search was performed in Ovid/MEDLINE, Scopus, Web of Science, and the Cochrane Library to identify studies assessing salivary biomarkers in pediatric appendicitis. Eligible studies included children with suspected or confirmed appendicitis and evaluated the diagnostic accuracy of salivary markers compared to clinical, laboratory, or imaging standards. Results: To date, only three salivary biomarkers have been investigated. Leucine-rich α-2-glycoprotein 1 (LRG1) demonstrated high specificity of 100% but low sensitivity of 35–36%, with diagnostic accuracy ranging from AUC 0.77 to 0.85. C-reactive protein (CRP) showed excellent diagnostic performance with sensitivity of 91.3% and specificity of 95.4% (AUC 0.97), and strong correlation with serum CRP (ρ = 0.96). Irisin showed sensitivity of 90% and specificity of 60% with estimated AUC around 0.75, suggesting potential as an adjunct marker but limited as a standalone test. Conclusions: Salivary biomarkers in pediatric appendicitis are promising but remain underexplored, with evidence limited to small, single-center studies totalling fewer than 300 patients. Their advantages include feasibility, tolerability, and suitability for integration into point-of-care testing. Future research should focus on multicenter validation, development of multi-marker salivary panels, and application of biosensor technologies. With further evidence, salivary diagnostics could complement existing strategies and improve the accuracy and child-friendliness of appendicitis care.

Background: Surgical site infection (SSI) remains a major concern in pediatric urological reconstructive surgery. Antibacterial-coated absorbable sutures like Monocryl Plus^® have been introduced to reduce SSI, but evidence in pediatric populations is limited. This study aimed to compare outcomes between Monocryl^® and Monocryl Plus^® sutures in common pediatric urological procedures. Methods: A retrospective review was conducted of all children who underwent reconstructive urological surgery for hydronephrosis, vesicoureteral reflux (VUR), or hypospadias at the University Hospital of Split between January 2008 and December 2025. A total of 653 patients were included: 149 with hydronephrosis, 187 with VUR, and 317 with hypospadias. Patients were grouped based on suture type (Monocryl^® vs. Monocryl Plus^®). The primary outcome was SSI within 30 days after surgery; secondary outcomes included overall complications, reoperations, readmissions, and length of hospital stay. Results: SSI occurred less frequently with Monocryl Plus than with Monocryl (3.8% vs. 6.9%, p = 0.04). The median length of stay was shorter in the Monocryl Plus group (5 days, IQR 4–7) compared to Monocryl (6 days, IQR 5–8; p = 0.02). Overall complication rates were 6.1% vs. 10.0% (p = 0.07), early complications 4.6% vs. 8.0% (p = 0.06), and late complications 2.3% vs. 4.2% (p = 0.18), favouring Monocryl Plus but without statistical significance. Reoperation was required in 1.8% vs. 3.4% (p = 0.19), and readmission in 2.6% vs. 5.0% (p = 0.12). Subgroup analysis showed minimal differences in hydronephrosis (all p > 0.6), modest reductions in VUR (SSI 8.1% vs. 4.4%, p = 0.21), and significant differences in hypospadias (SSI 7.8% vs. 4.2%, p = 0.04; fistula 12.2% vs. 6.5%, p = 0.03). Multivariate regression confirmed Monocryl Plus as independently associated with lower odds of SSI (OR 0.55, 95% CI 0.30–0.98, p = 0.04) and prolonged hospitalization >7 days (OR 0.59, 95% CI 0.38–0.91, p = 0.02). Conclusions: In pediatric urological reconstructive surgery, Monocryl Plus sutures were associated with significantly fewer SSIs and shorter hospital stays compared to traditional Monocryl. Although the overall complication, reoperation, and readmission rates showed nonsignificant trends favouring Monocryl Plus, the most notable benefits appeared in hypospadias repair, suggesting that suture choice might influence outcomes in this subgroup.