High-dose penicillin to prevent postoperative wound sepsis after ileocolorectal operations

Two hundred and twenty-two patients were admitted to a controlled trial to investigate the effect of penicillin on the prevention of postoperative wound infection after ileocolorectal operations. The study group was treated with 5 MIU of penicillin intravenously twice daily for 4 days, starting at operation, together with an intraincisional injection of penicillin at wound closure. The rate of wound infection was 11/93 (11.8%), compared with 15/92 (16.3%) in the control group, which was given a regimen of 2 MIU penicillin and 0.5 g streptomycin twice daily for 5 days; no difference existed between these sepsis rates (p less than 0.05). Measurements of the operation wounds per- and post-operatively showed a mean infected wound length of 7.3 +/- 4.0 cm, this being only one third of the original wound length, and no difference existed between the two treatment groups. A rate of partial wound infections of 1 in 10 seems acceptable after ileocolorectal operations, especially when achieved by penicillin therapy, which is inexpensive and free of serious risks.