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[Postoperative wound infections in elective colorectal surgery]
1Avdeling for tumorbiologi, Det Norske Radiumhospital, Oslo. kjersti.flatmark@labmed.uio.no
Background:
Surgical wound infections still represent a significant problem in colorectal surgery. We wanted to investigate the frequency of postoperative wound infections in patients who had elective colorectal surgery at Lillehammer County Hospital. By reviewing relevant literature we also wanted to assess the evidence base for using antimicrobial prophylaxis in colorectal surgery, which regimens are to be preferred, and the probable reduction in wound infections.
Material And Methods:
99 patients were followed up at 14 days after surgery; presence or absence of wound infection was noted. Samples for culture were obtained in all patients with suspected wound infection. Literature on the subject was studied focusing on systematic reviews.
Results:
Eight out of 99 patients (8%) had wound infections. In a systematic review of 147 studies comparing different antibiotic regimens, the overall infection rate for patients receiving antibiotic prophylaxis was 11%.
Interpretation:
The surgical wound infection rate was comparable with the results from relevant systematic reviews. The effect of antimicrobial prophylaxis is well documented. A combination of an anaerobic and an aerobic drug should be used, but no gold standard can be identified. Two adequate regimens have been investigated in controlled studies carried out in Norway.