Wound infection after metronidazole infiltration

Area of Science:

• Surgical Infection Prevention
• Clinical Trials in Surgery
• Pharmacological Interventions in Peritonitis

Background:

• High wound infection rates in Indian state-run hospitals are linked to malnutrition, anaemia, late presentation, septicaemia, and peritoneal contamination.
• Systemic antibiotics alone have proven insufficient in mitigating these high surgical site infection rates.

Purpose of the Study:

• To evaluate the efficacy of subcutaneous metronidazole infiltration versus saline irrigation in reducing wound infection rates.
• To assess the safety of local metronidazole infiltration in patients undergoing exploratory laparotomy for perforation peritonitis with pyoperitoneum.

Main Methods:

• A comparative study involving 60 patients with perforation peritonitis and pyoperitoneum undergoing exploratory laparotomy.
• Patients were randomized into two groups: Group A (saline irrigation) and Group B (subcutaneous metronidazole infiltration).
• Wound infection rates and local complications were monitored and compared between the two groups.

Main Results:

• Group A (saline irrigation) exhibited a wound infection rate of 66.6%.
• Group B (metronidazole infiltration) showed a significantly lower wound infection rate of 26.6% (P < 0.01).
• No local complications were attributed to the subcutaneous infiltration of metronidazole.

Conclusions:

• Local subcutaneous infiltration of metronidazole is a safe and effective strategy for controlling wound infections.
• This intervention demonstrates significant potential in reducing surgical site infections in cases of perforation peritonitis with pyoperitoneum.
• The findings suggest a valuable addition to the management protocols for high-risk abdominal surgeries.