title: Umbilical Microflora, Antiseptic Skin Preparation, and Surgical Site Infection in Abdominal Surgery.
abstract: BACKGROUND
  Surgical site infections (SSI) following abdominal surgery are frequent and a major cause of postoperative morbidity and prolonged hospital stay. Besides antibiotic prophylaxis, antiseptic skin preparation is an important measure to prevent SSI.
  
  
  METHODS
  Here we prospectively analyzed the effectiveness of antiseptic skin preparation in a cohort of 93 patients undergoing laparotomy, with special emphasis on the umbilical region.
  
  
  RESULTS
  The microflora of the umbilicus contained a large number of resident (mostly staphylococci species and corynebacteria) and transient germs (including enterococci species). Following antiseptic skin preparation, bacteria could still be cultured from 24.7% of the patients' umbilici. In case of postoperative SSI, only one of seven SSI was caused by the microorganism that was present in the umbilicus before and after skin preparation.
  
  
  CONCLUSIONS
  Antiseptic skin preparation fails to completely eradicate the microflora of the umbilical region in one quarter of the patients. However, at least in abdominal surgery, the vast majority of SSI are caused by intra-abdominal contamination rather than the skin microflora.
authors.affiliation: 1 Department of Surgery, Technische Universität München , Munich, Germany .
authors.forename: Jörg
authors.initials: J
authors.lastname: Kleeff
authors.affiliation: 1 Department of Surgery, Technische Universität München , Munich, Germany .
authors.forename: Mert
authors.initials: M
authors.lastname: Erkan
authors.affiliation: 1 Department of Surgery, Technische Universität München , Munich, Germany .
authors.forename: Carsten
authors.initials: C
authors.lastname: Jäger
authors.affiliation: 1 Department of Surgery, Technische Universität München , Munich, Germany .
authors.forename: Maximilian
authors.initials: M
authors.lastname: Menacher
authors.affiliation: 2 Institute of Medical Microbiology and Immunology, Technische Universität München , Munich, Germany .
authors.forename: Friedemann
authors.initials: F
authors.lastname: Gebhardt
authors.affiliation: 1 Department of Surgery, Technische Universität München , Munich, Germany .
authors.forename: Mark
authors.initials: M
authors.lastname: Hartel
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000494:pharmacology / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology*; D014472:Umbilicus / Q000382:microbiology*; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local