[The evaluation of skin disinfection efficacy and its influence on prevalence of surgical site infections in patients subjected to laparoscopic cholecystectomy].
Laparoscopic cholecystectomy (LC) is "the method of choice" in the treatment of cholelithiasis and its' complications. LC is not devoid of complications, among others, surgical site infection (SSI) but as a result of minimalisation of surgical trauma and immunosuppression after surgery, percentage of SSI is lower than after conventional cholecystectomy. Skin disinfection carried out before operation is thought to minimalise risk of infective complications after LC. 150 patients who had laparoscopic cholecystectomy carried out, were included in prospective study. Efficacy of skin disinfection was based on microbiological assessment including swabs from the umbiliculus before and after skin disinfection, and samples of exsudate or discharge from surgical site (if any). There were 133 (88.6%) patients with positive result of the umbilical swab before the disinfection of the skin, whereas 26 (17.3%) patients had bacteria isolated from the umbilical swab after the disinfection. Among these 26 patients in 19 (73.1%) cases the same species of bacteria were isolated before and after skin disinfection. Among 19 patients with inefficient skin dissinfection in 2 cases we observed SSI. In one of them the same strains of bacteria were isolated from umbilical swab and surgical site. Analysis of drug sensitivity of these isolates showed strict correlation. There were 16 cases of SSI in the whole group and it's rate was 10,6%. Skin disinfection before LC is not fully efficient. Inefficiency of skin disinfection does not increase risk of SSI. Skin dissinfection reduce microbial flora but does not protect from SSI provoked by these microbials.
Bieńkowski
Marcin
M
Oddział Chirurgiczny, Wielospecjalistyczny Szpital Miejski im. E. Warmińskiego w Bydgoszczy.
Gospodarek
Eugenia
E
Olejarz
Aleksander
A
Deptuła
Aleksander
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D004203:Disinfection / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000382:microbiology / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012306:Risk; D012867:Skin / Q000382:microbiology*; D013530:Surgical Wound Infection / Q000382:microbiology* / Q000517:prevention & control*; D016896:Treatment Outcome; D014472:Umbilicus / Q000382:microbiology
D000891:Anti-Infective Agents, Local