A CLINICAL STUDY OF POSTOPERATIVEWOUND INFECTION IN ATERTIARY CARE HOSPITAL

Abstract

Introduction: Patients undergoing surgical procedures unfortunately end up having infection at the site of surgical wound called as post operative wound infection. Spectrum of infection varies from a small stitch abscess to tissue destruction and septicemia. The study aims to determine the incidence of wound infection, factors influencing the incidence, organisms involved and their sensitivity towards antimicrobial agents.

Methods: Study was conducted in a 1500 bedded tertiary care hospital. Hospitalized patients who were to be operated of age >15 years of either sex were included. Patients suffering from chronic infections like diabetic ulcer, gangrene etc, were excluded. Pre-operative history, operative notes and post operative observation including culture and antimicrobial sensitivity were done.

Results: 18% of post operative wounds were found to be infected, incidence of infection in clean wounds was 11.36% and in dirty wounds it was 33.33%. Extremes of body mass index, increasing age, duration of operation, pre operative hospital stay and poor nutritional status lead to increase in incidence. 77.78% of total infected wounds had gram -ve bacteriae mainly E. coli, Proteus, Klebseilla and P. aeruginosa. S. aureus was found in 22.21% of infected cases. Maximum sensitivity was found with imipenem and amikacin.

Conclusion: No two medical institutions have an exact same environment so infection rates would fluctuate within an institution at different times and in between different institutions. A quality control study at different setups will point out to factors which can be worked on in general, namely a shorter pre-op stay, stratifying patients by cumulating risk factors and paying extra attention at wound care in these patients.