Abstract:
To determine the magnitude of postoperative clean wound infection,
some predisposing factors, surveillance, their current pattern and
antimicrobial susceptibility among general surgical patients
undergoing clean operations.
METHODS
Patients who were scheduled for and had elective clean operations
from June 1999 to January 2000 were followed for 30 days. Their
demographic data were obtained, wounds examined and those who
were found to have infected wounds, had pus swabs obtained for
culture. Bacteriological pattern and antimicrobial susceptibility tests
were conducted. A study of some predisposing factors was also done.
RESULTS
Of the 476 patients who had clean operations done during the study
period, 464 were registered. They comprised of 285 (60.4%) males and
179 (37.2%) females. Sixty(12.9%) patients were clinically found to
have wound infection of whom 47(10.1 %) had positive cultures. Forty
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(85.7%) patients had the diagnosis of wound infection made before
discharge and the remaining 7(14.3%) patients were diagnosis as
outpatients. Predominantly, the isolates consisted of Staphylococcus
aureas (36.1%), Klebsiella spp (31.2%), Escherichia coli (14.8%) and
other organisms were less frequently isolated.
CONCLUSION
The magnitude of surgical wound infection obtained is unacceptably
high. Prolonged preoperative hospitalization and prolonged operation
duration were found to significantly predispose to wound infection.
The patients' age and sex, the surgeon's rank, surgical scrub, shaving,
and the ward and theatre environment were not found to be
statistically significant risk factors. Patients who -suffered
postoperative wound infection had a significantly prolonged
postoperative hospitalization as well.
The operating theatre needs modifications that can suite the
requirements of a standard operating suite. Laxity in adherence to the
norms of the conduct in the operating theatre was found to exit and it
requires emphasis of the continuing education among the theatre
personnel. Also a more extensive and long-term study that will
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evaluate the risk factors further as well as a surveillance plan that can
be suitable in our environment is recommended.
