Wound infection following biliary surgery. A prospective surgery

Biliary surgery in general, with cholecystectomy in particular, is probably the commonest major elective abdominal operation worldwide. A prospective study has been completed on 141 biliary operations in which intra-operative bile swabs were taken, and other risk factors for wound infection sought....

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Bibliographic Details
Published inInternational surgery Vol. 76; no. 2; p. 77
Main Authors al-Awami, S M, al-Breiki, H, Abdul-Khader, A S, Twum-Danso, K, Grant, C, Wosornu, L
Format Journal Article
LanguageEnglish
Published Italy 01.04.1991
Subjects
Adolescent
Adult
Anti-Bacterial Agents - therapeutic use
Biliary Tract Surgical Procedures - adverse effects
Child
Child, Preschool
Cholecystectomy - adverse effects
Emergencies
Female
Humans
Incidence
Infant
Male
Middle Aged
Premedication
Prospective Studies
Risk Factors
Surgical Wound Infection - drug therapy
Surgical Wound Infection - epidemiology
Surgical Wound Infection - etiology
Surgical Wound Infection - microbiology
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Summary:Biliary surgery in general, with cholecystectomy in particular, is probably the commonest major elective abdominal operation worldwide. A prospective study has been completed on 141 biliary operations in which intra-operative bile swabs were taken, and other risk factors for wound infection sought. Patients' characteristics were: males 51, females 90 (1:1.8); mean age 42.4 +/- 16 years; mean Quetelet index for adults was 32 +/- 5. The operations were: emergencies 10, simple-cholecystectomies 112, and choledochotomies (including other concomitant procedures) 29. The observed wound infection rates were: overall 7.8%, simple cholecystectomy 3.6% and choledochotomies 24.1%, figures which agree closely with the national and international literature. The infected patients consumed, on average, 7 days more in hospital than the uninfected ones. We found three major risk factors for wound infection: patients aged 40 years or older (over 4-fold), choledochotomy (over 6-fold), and microbiologically proven wound co-ntamination (9-fold). We conclude that, given the consistently low (less than 4%), incidence of wound infection following simple cholecystectomy, routine antibiotic prophylaxis in this subset is probably unjustified.
ISSN:0020-8868