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[Bacterial count as an infection prognostic factor in the delayed primary closure of abdominal surgical wounds]
M F Herrera Hernández1, G Romero Zárate, J Sifuentes Osornio
1Departamento de Cirugía, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Study Objective:
To determine the prognostic value of the soft-tissue biopsy to handle contaminated or infected surgical wounds with delayed primary closure.
Design:
Comparative, prolective, blind and observational.
Place:
Referral tertiary care center.
Patients:
We included 70 patients distributed in two groups: Group I: 50 patients who underwent contaminated or infected abdominal surgery; and Group II: 20 patients who underwent clean or clean contaminated abdominal surgery and developed surgical wound abscess.
Interventions:
Daily cleaning and water irrigation and periodic debridement were done in all the cases; after five days (excluding infection), two tissue biopsies for quantitative culture and wound closure were performed.
Measurements And Main Results:
In Group I, nine of 26 patients (35%) with positive culture (greater than 10(5) colony forming units/g) developed infection and none of 24 with negative culture (p less than 0.01, Fisher); the negative predictive value (nPV) was 100% and the positive predictive value (pPV) was 35%. In Group II, seven of 12 patients with positive culture and one of eight with negative culture developed infection (p less than 0.05); the nPV was 87% and the pPV was 58%.
Conclusions:
The biopsy of soft-tissue seems to be a helpful tool for the treatment and prognosis of infected or contaminated surgical wounds.