ABSTRACT
Background: An emergency laparotomy is a commonly performed operation by general surgeons where the abdomen is opened and the abdominal organs examined for any injury or disease. A few major indications for an emergency laparotomy are perforation peritonitis, acute intestinal obstruction, burst appendix and blunt or penetrating abdominal injuries either due to roadside accidents, fall from height or gun shot or stab injuries. The study aims to see the causative organism of wound infection and prevent misuse of antibiotics in infected wounds following emergency laparotomy.Material & Methods:This observational study was carried out in the Department of Surgery, Khulna Medical College, Khulna from July 2008 to June 2009. A total of 58 specimens consisting of wound swabs, pus, purulent exudates or wound discharge were collected from patients who had emergency laparotomy at Khulna Medical College.Results:Out of 58 patients with abdominal operation developed wound infection following emergency laparotomy, 14 cases were ileal perforation, 19 cases were duodenal ulcer perforation, and 9 cases were sigmoid volvulus, and F13 cases were small intestinal obstruction and 3 were blunt abdominal trauma. Among 58 postoperative abdominal wound infected cases all require antibiotics and regular dressing 60.34% require a secondary stitch 25.86% require no secondary stitch and 13.79% required wound excision with a secondary stitch.Conclusions:Postoperative complications are more common after emergency laparotomies compared to elective laparotomies. Maximum complications were found in patients with delayed presentation or in patients having any associated co-morbidities. Therefore, early detection and immediate intervention with better postoperative care can minimize postoperative complications. The present study suggests that proper awareness among rural populations, adequate health education to seek prompt medical aid, a good referral and efficient transportation can reduce the delayed presentation which in turn will prevent postoperative complications following emergency laparotomy.