Infections following damage control laparotomy with abdominal packing

Area of Science:

• Surgical Infections
• Critical Care Medicine
• Infectious Diseases

Background:

• Damage control laparotomy (DCL) with abdominal packing is a critical surgical procedure.
• Postoperative infections are a significant concern in patients undergoing DCL.

Purpose of the Study:

• To describe the incidence and types of postoperative infections in patients after DCL with abdominal packing.
• To identify risk factors associated with de novo postoperative infections in this patient cohort.

Main Methods:

• Retrospective review of 26 patients undergoing DCL with abdominal packing at Jinling Hospital over a 5-year period.
• Analysis of infection types, causative pathogens, antibiotic resistance, and correlation with pack status.
• Multivariate regression analysis to identify independent risk factors for de novo infection.

Main Results:

• A high incidence of postoperative infections (57.7%) was observed.
• Pneumonia/lower respiratory tract infection and bacteraemia were the most common infections.
• Pseudomonas aeruginosa, staphylococcal species, Acinetobacter baumannii, and Klebsiella species were frequently isolated pathogens, often exhibiting antibiotic resistance.
• Pre-existing abdominal infection and increased number of surgical procedures were identified as independent risk factors for de novo infection.

Conclusions:

• Patients undergoing DCL with packing have a high risk of postoperative infections.
• Infections are often caused by multidrug-resistant pathogens common in intensive care units.
• Early identification and management of pre-existing abdominal infection and minimizing repeat surgeries are crucial for reducing de novo infection risk.