CHOLECYSTECTOMY AND OPERATIVE WOUND INFECTION

Abstract

Purpose of the study:-The recognition of the factors that can reduce the incidence of wound infection after simple cholecystectomy. -The relation of bacterial flora of the bile to that of the wound and - The value of prophylactic chemotherapy. Material - results: Ιn the period Jan - Dec 1989 in the 2nd Surgical Ρrοp. Dept, 189 patients (43 males, 146 females) underwent cholecystectomy. Eight patients were operated on urgenlty. Ιn 23 patients the gall bladder was opened during the operation resulting in contamination of the operative field. Wound infection was recognized in 3 out of the 23 patients ( 13%). The mean value of the preoperative hospitalization time was 3,5 days. The antibiotics used during the operation were aztreonam, cefuroxim, cefotaxime and metronidazole. Wound infection was developed in 15/189 patients, 14 after effective and one after urgent operation. The cultures of the wound exudate were positive in 12/15 pts (80%) and the isolated organism was staphylococcus Ρ+ and Ρ-. Positive cultures of gallbladder bile and drainage were found in 11 /15 pts (73%), but with different bacterial flora. Staphylococcus was not sensitive to the used antibiotics. Results: -Superinfection is the main cause of wound infection after simple cholecystectomy. Perioperative chemoprophylaxis was of no value and -better results could be attempts with reduction of preoperatίve hospitalization time and early detection.