Surgical site infection in clean and clean-contaminated cases.

The rate of surgical site infections and the frequency of various pathogens causing surgical site infection with their antibiotic resistance pattern in general surgery units were studied. In the period from May 2001 to July 2002, 190 patients admitted for surgery (clean and clean-contaminated elective cases) were assessed preoperatively, intraoperatively and postoperatively. Normal microbial flora was studied within 24 to 48 hours of admission and patients were followed up to 30 days postoperatively. Infected wounds were studied bacteriologically and clinically. The overall infection rate was 8.95%. Surgical site infection rate was 3.03% in clean surgeries and 22.41% in clean-contaminated surgeries. Significant increase was seen in surgical site infection rate with an increase in preoperative stay. The increase in duration of surgery was associated with a significant rise in the rate of surgical site infection. Surgical site infection rate was much higher (22.41%) in cases where a drain was used than in non-drained wounds (3.03%). The most common isolate was Staphylococcus aureus followed by Pseudomonas aeruginosa.

Bifid liver in a patient with diaphragmatic hernia.

Liver malformations including lobe and segmental abnormalities are rare. We report a 65-year-old lady with complaints of breathlessness and fullness after meals for two months. Investigations revealed a diaphragmatic hernia on the right side with a bifid liver; the right lobe of the liver was among the hernia contents. The lady is asymptomatic after surgical repair.