Surveillance of surgical site infections after cholecystectomy
DOI:
https://doi.org/10.18203/2349-2902.isj20185025Keywords:
Antibiotic prophylaxis, Laparoscopic cholecystectomy, Open cholecystectomy, Surgical site infectionsAbstract
Background: The objective of present study is find out various patient factor including demographic data as well as operative data on occurrence of surgical site infection in patients of cholecyctectomy.
Methods: A Prospective observational study of 273 patients of cholecystitis undergoing cholecystectomies for Surveillance of surgical site infections was conducted in the Department of General Surgery at the SSG hospital and Medical College Baroda during a period from 1st December 2013 to 30th November 2015. All patients operated for cholecystectomy are included irrespective of technique. Data collected from each patient were: Case start date and time, case end date and time, discharge date & time, case length, postoperative length of stay in hospital, patients characteristics (age, sex, ASA score), operative characteristics like, pathological diagnosis report of specimen, microorganism isolated based on culture report and antibiotic resistance pattern from infected wounds, antibiotic prophylaxis given perioperatively and antibiotics administered to treat SSI`s, intra operative spillage and bleeding, date of infection, urgent/elective procedure.
Results: During the period of 24 months total 273 patient were undergone cholecystectomy out of which 12 (4.3%) patients were developed SSI. SSI rate is affected by various factors which are statistically significant are sex of patients, age, type of procedure, ASA score >3.
Conclusions: The overall incidence of SSIs in the present study was 4.3%. The rates of SSI were more in patient with higher age, with male sex, emergency procedure and higher ASA score.
References
Pitchumoni C. increasing prevalence of gallstones; diagnostic and therapeutic options. Medicine Update. 2010;20:486-90.
Stinton LM, Shaffer EA. Alternative formats. Gut. 2012;6(2):172-87.
Cuevas A, Miquel JF, Reyes MS, Zanlungo S, Nervi F. Diet as a risk factor for cholesterol gallstone disease. J Am Coll Nutr. 2004;23(3):187-96.
Harju J, Juvonen P, Eskelinen M, Miettinen P, Pääkkönen M. Minilaparotomy cholecystectomy versus laparoscopic cholecystectomy, Surgical Endoscopy and Other Interventional Techniques, Springer. April 2006;20(4):583-6.
Jawien M, Wojkowska-Mach J, Rozanska A, Bulanda M, Heczko PB. Surgical site infection following cholecystectomy: comparison of procedures performed with and without a laparoscope. Int J Infection Control. 2008 Sep 29;4(1).
Richards C, Edwards J, Culver D, Emori TG, Tolson J, Gaynes R, National Nosocomial Infections Surveillance (NNIS) System. Does using a laparoscopic approach to cholecystectomy decrease the risk of surgical site infection?. Ann Surg. 2003 Mar;237(3):358.
Gharde P, Swarnkar M, Waghmare LS, Bhagat VM, Gode DS, Wagh DD, Muntode P, Rohariya H, Sharma A. Role of antibiotics on surgical site infection in cases of open and laparoscopic cholecystectomy: a comparative observational study. J Surgical Tech Case Report. 2014;6(1):1-4.
Den Hoed PT, Boelhouwer RU, Veen HF, Hop WC, Bruining HA. Infections and bacteriological data after laparoscopic and open gallbladder surgery. J Hospital Infection. 1998 May 1;39(1):27-37.
Brill A, Ghosh K, Gunnarsson C, Rizzo J, Fullum T, Maxey C, et al. The effects of laparoscopic cholecystectomy, hysterectomy, and appendectomy on nosocomial infection risks. Surgical Endoscopy. 2008 Apr 1;22(4):1112.
Saud JD, Al-Hail MC. Surgical site infections after laparoscopic cholecystectomy. Basrah J Surgery. 2010 March 16.
Kaye KS, Schmit K, Pieper C, Sloane R, Caughlan KF, Sexton DJ, et al. The effect of increasing age on the risk of surgical site infection. J Infectious Dis. 2005 Apr 1;191(7):1056-62.
Bogdanic B, Bosnjak Z, Budimir A, Augustin G, Milosevic M, Plecko V, et al. Surveillance of surgical site infection after cholecystectomy using the hospital in Europe link for infection control through surveillance protocol. Surgical Infections. 2013 Jun 1;14(3):283-7.
Siddiqui K, Khan AF. Comparison of frequency of wound infection: open vs laparoscopic cholecystectomy. J Ayub Med Coll Abbottabad. 2006;18(3):21-4.
Romy S, Eisenring MC, Bettschart V, Petignat C, Francioli P, Troillet N. Laparoscope use and surgical site infections in digestive surgery. Ann Surg. 2008 Apr 1;247(4):627-32.
Mehraj A, Naqvi MA, Feroz SH, ur Rasheed H. Laparoscopic cholecystectomy: an audit of 500 patients. Journal of Ayub Medical College Abbottabad. 2011 Dec 1;23(4):88-90.
Jan WA, Ali IS, Shah NA, Ghani A, Khan M, Khan AS. The frequency of port-site infection in laparoscopic cholecystectomies. J Postgrad Med Institute (Peshawar-Pakistan). 2011 Aug 15;22(1).
Diez J, Arozamena CJ, Ferraina P, Franci JM, Ferreres A, Lardies JM, et al. Relation between postoperative infections and gallbladder bile leakage during laparoscopic cholecystectomies. Surgical Endoscopy. 1996 May 1;10(5):529-32.
Anderson DJ. Surgical site infections. Infect Dis Clin North Am. 2011;25(1):135-53.
Hazrah P, Oahn KT, Tewari M, Pandey AK, Kumar K, Mohapatra TM, et al. The frequency of live bacteria in gallstones. HPB. 2004 Mar;6(1):28-32.
Friedman GD. Natural history of asymptomatic and symptomatic gallstones. Am J Surg. 1993 Apr 1;165(4):399-404.
Kumar A, Patodia M, Pandove PK, Sharda VK, Pahwa S. Role of antibiotic prophylaxis in laparoscopic cholecystectomy: a randomized prospective study. J Int Med Sci Acad. 2013;26(4):209-11.
Uchiyama K, Kawai M, Onishi H, Tani M, Kinoshita H, Ueno M, et al. Preoperative antimicrobial administration for prevention of postoperative infection in patients with laparoscopic cholecystectomy. Dig Dis Sci. 2003 Oct 1;48(10):1955-9.
Lippert H, Gastinger J. Antimicrobial prophylaxis in laparoscopic and conventional cholecystectomy. Chemotherapy. 1998;44(5):355-63.
Mirani AJ, Suchdev SD, Jatoi AH, Haseeb A, Idrees S, Younus SM. Use of antibiotic prophylaxis in low-risk laparoscopic cholecystectomy is unnecessary: A clinical trial. Pak J Surg. 2014;30(2):175-9.
Harling R, Moorjani N, Perry C, MacGowan AP, Thompson MH. A prospective, randomised trial of prophylactic antibiotics versus bag extraction in the prophylaxis of wound infection in laparoscopic cholecystectomy. Ann Royal Coll Surgeons England. 2000 Nov;82(6):408.
Hirai CA, Murariu D, Cooper MD, Oishi AJ, Nishida SD, Lorenzo CS, Bueno RS. Single-incision Laparoscopic Cholecystectomy at Community Hospitals in Honolulu, Hawai ‘i: A Case Series. Hawai'i J Med Public Health. 2013 Dec;72(12):428.
Memon W, Khanzada TW, Samad A, Laghari MH. Complications of laparoscopic cholecystectomy at Isra University hospital, Hyderabad. Pak J Med Sci. 2009 Jan 1;25(1):69-73.
Berggren U, Gordh T, Grama D, Haglund U, Rastad J, Arvidsson D. Laparoscopic versus open cholecystectomy: hospitalization, sick leave, analgesia and trauma responses. Br J Surg. 1994;81(9):1362-5.
Rooh-ul-Muqim FG, Iqbal J, Akbar J, Khan Z, Samiullah MZ, Wazir MA. Comparison in Terms of Postoperative Morbidity and Hospital Stay between Open Cholecystectomy and Laparoscopic Cholecystectomy. World J Laparoscopic Surg. 2008 Sep 4;1(3):17-21.
