Surgical site infection; evaluation of causative organisms involved

Wound infection can be defined as invasion of organisms through tissues following a breakdown of local and systemic host defenses. The basic principles of wound care and antisepsis introduced during the past century improved surgery dramatically. Evaluation of causative organisms which evolved in the surgical site infection [elective abdominal surgery] at surgical unit of Liaquat university hospital Jamshoro. This prospective observational study was contains 103 patients undergoing elective, abdominal surgery were included in this study. Surgical wound categories i.e. clean, clean contaminated, were included. Prophylactic antibiotics were given in all cases. Primary closure of wounds was employed in all cases. Follow up period was 30 days postoperatively. All cases were evaluated for postoperative fever, redness and swelling of wound margins, collection and discharge of pus. Cultures were taken from all the cases with any of the above findings. The mean age of the patient was 37 years with male to female ratio of 1:5:1. The overall rate of wound infection was 13.04%. Most frequently involved pathogen was E.col 33.33% followed by Staph Aureus 20%, Klebsiella 20%, proteus 13.33%, Pseudomonas 6.66% and no organism was isolated in 6.66% cases. Most effective antibiotics were cephalosporins, quinolones and aminoglycosides' whereas septran, erythromycin and tetracycline's were ineffective. Surgical wound infections are quite common. Time of postoperative hospital stay was twice longer in infected case. Male sex, old age, anemia, longer duration of operation and wound class were significant risk factors. Most common organims are found in this study E-Coli, Kllebcella and Staph Aureus, these are mostly sensitive to cephalosporins, quinolones and aminoglycosides

Current pattern and diagnosis of small bowel obstruction in the patients of rural areas

Objective of this study to determine the clinical presenting factors including diagnosis and risk factors of the patients those admitted with small bowel obstruction. Observational study. This study was carried out at the Departments of General Surgery, Peoples Medical University and Health Science Nawabshah and Isra University Hospital Hyderabad from March 2013 to Aug 2013. After admission detailed history, physical examination, ultrasound, X-ray abdomen erect and supine and all routine baseline laboratory investigations were carried out. CT scan was done in the selected patients. Final diagnosis was done by laparotomy which was attempted after thorough initial assessment and investigations. Total 50 patients were included in the study of the rural areas of the Sindh, from all of them male were in majority. On the clinical presenting features Nausea, Constipation and Abdominal pain were most common with the percentage of 92%, 80% and 78% while other presenting features as; Vomiting, Abdominal tenderness, Abdominal distension, Fever, Epigastrium pain, Rectal bleeding and Rebound tenderness were with the percentage of 40%, 42%, 22%, 38%, 30%, 16%, 10% and 26% respectively. On the diagnosis adhesion was found as most common. In the conclusion of this study adhesion found as most common and leading cause of small bowel obstruction