Prevention of deep wound infection in morbidly obese patients by infusion of an antibiotic into the subcutaneous space at the time of wound closure.
BACKGROUND
Wound infections have been reported to occur in as many as 15% of wounds following the open procedure for gastric bypass in morbidly obese patients, resulting in significant disability, an increased health-care expenditure, and even death.


METHODS
This study was performed to assess the potential for reduction of wound infection in patients undergoing open gastric bypass by using a multimodal application of measures including infusion of an antibiotic (kanamycin) into the wound after closure and allowing it to dwell for 2 hours. Follow-up was for a minimum of 6 weeks.


RESULTS
Of 400 consecutive evaluable patients, none had a wound infection which started in the subcutaneous fat or fascia. One patient had a stitch abscess, two had superficial infections secondary to wound separation after suture removal, and one had infection after spontaneous evacuation of a seroma.


CONCLUSIONS
Using an infusion of kanamycin into the wound and allowing it to dwell for a 2-hour period, along with other standard preventive measures, eliminated primary deep subcutaneous and fascial wound infections after open gastric bypass procedures.
The UC Surgeons Center for Surgical Weight Loss, Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0558, USA. jwesley.alexander@uc.edu
J Wesley
JW
Alexander
Rosemary
R
Rahn
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D015390:Gastric Bypass; D006801:Humans; D007612:Kanamycin / Q000008:administration & dosage*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D013530:Surgical Wound Infection / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D007612:Kanamycin