Correlation Of Drain Tip Culture And Surgical Site Infections In Patients Undergoing Emergency Exploratory Laparotomy
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 8
Abstract
Introduction - Incidence of surgical site infections is quite high after emergency exploratory laparotomies and the peritoneal cavity is routinely drained by abdominal drains in these patients. Since no study on abdominal drain tips had been carried out in the past, we studied the correlation of drain tip culture and surgical site infections in these patients. The report of the positive drain tip cultures was used for guiding a specific antibiotic in a particular patient. Material & Methods – This study was conducted on 75 patients in a tertiary care institute in North India. Patients more than 14 years of age undergoing emergency exploratory laparotomy for perforation peritonitis were included in the study. Abdominal drain tip was sent for culture and sensitivity. A clinico-bacteriological study was conducted and correlation of drain tip culture with surgical site infections was statistically analysed. Results and discussion – In our study, overall incidence of SSI was 50.66%. Gram-negative infections predominated and the commonest organism isolated was Escherichia coli. Overall incidence of positive drain tip culture was 44%. Incidence of positive drain tip culture in patients with SSIs was 63.15% and in patients without SSIs was 24.32% (p=0.0007). There was significant correlation of drain tip culture with wound culture and surgical site infections. Conclusion - We conclude that abdominal drain tips, after removal, should be routinely sent for microbiological examination in patients undergoing emergency laparotomy specially if the patient develops signs of infection and wound swab culture cannot be obtained or is sterile. Drain tip culture helps in guiding a specific antibiotic in these patients. Abdominal drains are routinely placed in the peritoneal cavity in emergency laparotomy. This study, first of its kind in surgical patients, opens up the idea of an important use of the abdominal drain “after it has served its desired purpose”. These patients are at higher risk of SSI and drain tip culture helps in dealing with infections in a better way.
Authors and Affiliations
Dr Chisel Bhatia1
Keywords
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