POSTOPERATIVE SURGICAL SITE INFECTION AND PROFILE OF MICROORGANISM IN ELECTIVE LAPAROTOMIES

Abstract

Laparotomy is one of the most common surgical procedures done by a surgeon. It is performed both as elective and an emergency procedure. Laparotomy procedures are prone to post-operative complications such as pain, fever, wound infection, wound dehiscence, incisional hernia, etc. The rate of these complications depends on preoperative antibiotic prophylaxis, skin antisepsis, control of contamination and surgical skills. SSI is the most common health-care-associated infection and is a cause of one-third of post-operative deaths. A prudent antibiotic prophylaxis and post-operative antibiotic management should be done. For successful management knowledge is necessary regarding the possible pathogens and their antibiotic resistance patterns. The aim of the study is to find out the incidence of SSI in elective laparotomies and to find out the type of pathogenic organism causing wound infection. This prospective observational study was conducted on 180 patients who had undergone elective laparotomy after taking an informed consent.Asterile swab for culture and sensitivity was taken Pre-operatively from incision site and sent to laboratory for assessment with normal culture technique. Repeat swabs for culture and sensitivity was done for patients with post-operative wound infection. Patients were followed up for 1 month. Out of 180 cases incidence of the SSI was seen in 17 cases of elective laparotomy (9.4%). Out of 17 SSI swab specimens 2 (11.8%) were Gram positive involving CONS pathogen, 13 (64.7%) were Gram negative involving E. coli, K.pneumoniae and Pseudomonas (41.2%, 29.4%, 5.9%) while no growth was observed in 11.8% specimens. SSIs were unaffected by demographic or operative variables. Surgical site infections were instrumental in prolonging the duration of hospital stay. Tigecycline and colistin were found to be 100 % sensitive for all the pathogens.