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[Infections following gastrointestinal surgery and prophylactic antibiotics]
Abstract:
Of the 1,396 patients who underwent gastroenterological surgery at our department in the past seven years, 132 (9.5%) developed surgical wound infections. The incidence of such infections varied greatly depending on the location and method of the operation. The causative organisms isolated from these infections were often the same as the normal bacterial flora in the organ that was the object of the surgery. Frequent factors of intra-abdominal infection, of which there were 62 cases, were leakage and intra-abdominal bleeding after extended operations in a compromised host. Antibiotics are not substitutes for careful surgical technique. For Escherichia coli and Klebsiella isolated from clinical specimens, we found that the antibiotics Cephalothin and Cefazolin did have satisfactory antibacterial activity. The first and second generation cephems seem suitable for use as prophylactic antibiotics against surgical wound infection. The best time to start giving prophylactic antibiotics was during the operation. Useful indicators of postoperative infection are the fever index, leucocytosis, CRP, and the erythrocyte sedimentation rate.
Insights
Surgical wound infections in gastroenterological surgery affect 9.5% of patients. Prophylactic antibiotics, like first and second-generation cephems, administered during surgery, are effective in preventing these infections.
Area of Science:
- Gastroenterological surgery
- Infectious disease epidemiology
- Surgical site infections
Context:
- Analysis of 1,396 gastroenterological surgeries over seven years.
- Identified a 9.5% incidence of surgical wound infections.
- Infection rates varied significantly by surgical site and procedure.
Purpose:
- To investigate the incidence and characteristics of surgical wound infections.
- To identify causative organisms and risk factors for intra-abdominal infections.
- To evaluate the efficacy of prophylactic antibiotics and identify early infection indicators.
Summary:
- Surgical wound infections occurred in 132 (9.5%) of 1,396 patients.
- Causative organisms often mirrored the normal flora of the operated organ.
- Leakage and bleeding were key factors in 62 intra-abdominal infections.
- First and second-generation cephems (Cephalothin, Cefazolin) showed efficacy against common pathogens.
- Prophylactic antibiotics are most effective when initiated during surgery.
- Fever index, leucocytosis, C-reactive protein (CRP), and erythrocyte sedimentation rate are useful infection indicators.
Impact:
- Highlights the importance of surgical technique over sole reliance on antibiotics.
- Suggests specific prophylactic antibiotic strategies for gastroenterological surgery.
- Provides valuable indicators for early detection of postoperative infections.
- Informs clinical practice regarding antibiotic prophylaxis and infection surveillance.