Risk of infection, infecting flora and treatment considerations in penetrating abdominal trauma

Infectious complications postoperatively for penetrating abdominal trauma are a major cause of morbidity, which contributes significantly to increased length of hospitalization stay and the cost of patient care. The results of recent studies have suggested that the probability of a major infection after traumatic intestinal perforation of the individual patient can be predicted from risk factors noted at the time of the operation. The factor most closely associated with the development of infection is peritoneal contamination by intestinal contents. Other significant risk factors (p < 0.05) are the number of organs injured, number of units of blood administered, ostomy formation for left colonic injury and patient age. The risk of patients being infected can be predicted and thereby used to guide postoperative treatment decisions. Adjusting trauma care choices in antibiotics, duration of antibiotic administration and incisional wound management could result in significant savings. Standard operative procedures, the use of parenteral antibiotics (the duration of which has been one to two days in most recent studies) effective against endogenous aerobic and anaerobic organisms and leaving the surgical incision open decrease the incidence of postoperative wound infection. Despite such preventive measures, major infection remains a problem.