title: Wound infection following biliary surgery. A prospective surgery.
abstract: Biliary surgery in general, with cholecystectomy in particular, is probably the commonest major elective abdominal operation worldwide. A prospective study has been completed on 141 biliary operations in which intra-operative bile swabs were taken, and other risk factors for wound infection sought. Patients' characteristics were: males 51, females 90 (1:1.8); mean age 42.4 +/- 16 years; mean Quetelet index for adults was 32 +/- 5. The operations were: emergencies 10, simple-cholecystectomies 112, and choledochotomies (including other concomitant procedures) 29. The observed wound infection rates were: overall 7.8%, simple cholecystectomy 3.6% and choledochotomies 24.1%, figures which agree closely with the national and international literature. The infected patients consumed, on average, 7 days more in hospital than the uninfected ones. We found three major risk factors for wound infection: patients aged 40 years or older (over 4-fold), choledochotomy (over 6-fold), and microbiologically proven wound co-ntamination (9-fold). We conclude that, given the consistently low (less than 4%), incidence of wound infection following simple cholecystectomy, routine antibiotic prophylaxis in this subset is probably unjustified.
authors.affiliation: Department of Surgery, King Fahd Hospital of the University, Al-Khobar, Saudi Arabia.
authors.forename: S M
authors.initials: SM
authors.lastname: al-Awami
authors.forename: H
authors.initials: H
authors.lastname: al-Breiki
authors.forename: A S
authors.initials: AS
authors.lastname: Abdul-Khader
authors.forename: K
authors.initials: K
authors.lastname: Twum-Danso
authors.forename: C
authors.initials: C
authors.lastname: Grant
authors.forename: L
authors.initials: L
authors.lastname: Wosornu
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D002763:Cholecystectomy / Q000009:adverse effects; D004630:Emergencies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011292:Premedication; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents