[Bacterial count as an infection prognostic factor in the delayed primary closure of abdominal surgical wounds].
OBJECTIVE
To determine the prognostic value of the soft-tissue biopsy to handle contaminated or infected surgical wounds with delayed primary closure.


METHODS
Comparative, prolective, blind and observational.


METHODS
Referral tertiary care center.


METHODS
We included 70 patients distributed in two groups: Group I: 50 patients who underwent contaminated or infected abdominal surgery; and Group II: 20 patients who underwent clean or clean contaminated abdominal surgery and developed surgical wound abscess.


METHODS
Daily cleaning and water irrigation and periodic debridement were done in all the cases; after five days (excluding infection), two tissue biopsies for quantitative culture and wound closure were performed.


RESULTS
In Group I, nine of 26 patients (35%) with positive culture (greater than 10(5) colony forming units/g) developed infection and none of 24 with negative culture (p less than 0.01, Fisher); the negative predictive value (nPV) was 100% and the positive predictive value (pPV) was 35%. In Group II, seven of 12 patients with positive culture and one of eight with negative culture developed infection (p less than 0.05); the nPV was 87% and the pPV was 58%.


CONCLUSIONS
The biopsy of soft-tissue seems to be a helpful tool for the treatment and prognosis of infected or contaminated surgical wounds.
Herrera Hernández
M F
MF
Departamento de Cirugía, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Romero Zárate
G
G
Sifuentes Osornio
J
J
D000009:Abdominal Muscles / Q000473:pathology / Q000601:surgery*; D001706:Biopsy; D015169:Colony Count, Microbial; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013530:Surgical Wound Infection / Q000382:microbiology* / Q000473:pathology / Q000628:therapy
La cuenta bacteriana como factor pronóstico de infección en el cierre primario tardío de heridas quirúrgicas abdominales.