Prospective bacteriologic study of women undergoing hysterectomy

A prospective bacteriologic study on 67 women undergoing either vaginal or abdominal hysterectomy was done to elucidate causes of debrile morbidity. Forty-one percent of the vaginal and 35% of the abdominal hysterectomy patients met the criteria for febrile morbidity postoperatively. Preoperative and 24-hour postoperative urine samples were obtained by transvaginal bladder tap, and the freshly cut edge of the vaginal cuff was routinely swabbed following removal of the uterus. In addition, the subcutaneous layer was cultured during closure of the abdominal wound. Escherichia coli, Enterococcus, and alpha- and beta-Streptococcus were the predominant organisms recovered. The importance of routine vaginal cuff cultures at the time of surgery for the treatment of postoperative morbidity is discussed.