ASSESSMENT OF VARIOUS FACTORS INFLUENCING WOUND INFECTION FOLLOWING ABDOMINAL SURGERY- A CLINICAL STUDY

Abstract

Background: Wound infection is greatly affected by size and depth of incision, site of surgery etc. The present study was conducted to determine various factors leading to wound infection following abdominal surgery. Materials & Methods: This study was conducted on 154 patients who underwent abdominal operations. Intra- operative factors such as type of incision used, type of antiseptic, pre- existing skin infection, placement of suture and length of operative time was recorded. Post- operative risk factors such as urinary catheterization, anticoagulant therapy etc. was recorded. Results: Common surgery performed was appendectomy in 14, CBD exploration in 12, hernioplasty in 8, pyelolithotomy in 23, cholecystectomy in 54, laparotomy in 36 and supra-pubic cystolithotomy in 7 cases. Out of 154 cases, 20 (12.9%) had wound infection. Out of 20 patients who had wound infection, ASA score 1 was present in 10, 2 in 5, 3 in 3, 4 in1 and 5 in 1. Operative time upto 60 minutes was seen in 11, 61-120 minutes in 6 and >121 minutes in 3 patients. 12 patients were diabetic, 7 were underweight, 6 were smokers, 11 were on steroid use and 3 had re-operation skin infection . Abdominal incision was vertical in 5, horizontal in 7 and oblique in 8. Skin antiseptic agent used was povidine- iodine in 13 and chlorhexidine in 7. Opening of digestive bowel was seen in 4 cases. Urine catheterization was required in 8 patients. Wound was clean in 7 and clean- contaminated in 13, drains were used in 10, 13 patients were on anti- coagulant therapy and 12 required blood transfusion Conclusion: Authors found that common risk factors for wound infection was diabetes, smoking, underweight, patients on steroids, oblique incision, clean- contaminated wound and anti- coagulant therapy.