Predictive value of bacterial analysis of laparotomy wounds

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COD: 16_2185_292-297 Categorie: ,

Mario Minutolo, Giovanna Blandino, Manuel Arena, Alessio Licciardello, Biagio Di Stefano, Raffaele Lanteri, Stefano Puleo, Antonio Licata, Vincenzo Minutolo

Ann. Ital. Chir., 2014 85: 292-297
Published online 20 February 2014

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BACKGROUND: Despite improvements in antibiotic prophylaxis, surgical site infections represent the most common postoperative
complication with important clinical consequences for patients.
AIM: The hypothesis that a bacterial analysis of the surgical wound in the operating room could predict the likelihood
of developing a clinical infection, and might allow a tailored and preemptive approach, aimed to reduce the consequences
of an infection, seems appealing. We would like to present a prospective study on the predictive value of the bacterial
analysis of laparotomy wounds.
MATERIAL OF STUDY: Seventy eight prospective patients undergoing surgery were included in the study. To evaluate the
risk factors associated with increased rate of wound infection, we performed a bacterial analysis of the wound.
RESULTS: 48 patients out of 78 (61%) had positive cultures. 23 patients out of 32 patients (72%) who didn’t receive
antibiotic prophylaxis were positive to the wound culture whereas 25 patients out of 46 patients (54%) grew positive
cultures in the group of patients that received antibiotic prophylaxis. None of the 30 patients with negative cultures
developed clinical infection. Only 6 patients out of 48 patients who had positive cultures (12.5%) developed wound
infection. Clinical infection occurred in 5 patients who had gram-negative contamination of the wound. No clinical
infection occurred in patients who had gram-positive contamination.
CONCLUSION: Wound cultures and their positivity are predictive tools to identify the patients that are at risk to develop
wound infection. The positive predictive value of the bacterial analysis of the wound was 12.5%.

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