Post-operative Infections and Microbiology in Patients who Underwent Damage Control Laparotomy with Abdominal Packing / 中华医院感染学杂志

ABSTRACT

OBJECTIVE To determine the prevalence of post-operative infections in patients who underwent damage control laparotomy(DCL) with abdominal packing and to identify the risk factors,mortality and predominant pathogens.METHODS A retrospective study of postoperative infections and microbiology in patients who underwent abdominal packing as an adjunct of DCL to control coagulopathic hemorrhage over a 5 year period(Feb 2002-Feb 2007) were performed.RESULTS A total of 26 patients were studied.Pneumonia/lower respivatory tract infection was the prominant type of infection(57.7%),followed by bacteremia(50.0%),urinary tract infection(15.4%) and wound infection(15.4%).Of the 244 organisms isolated from various sites,the most frequently isolated bacteria were Pseudomonas aeruginosa(27.0%),Staphylococcus species(15.6%),Acinetobacter baumannii(13.9%),and Klebsiella species(11.1%).No statistical correlation was found between positive packs and postoperative infection(P=0.10) or death(P=1.00).Multivariate regression analysis revealed that pre-existing abdominal infection(OR=22.4,P=0.02) and increased number of surgical procedures(OR=3.69,P=0.05) were the independent risk factors for post-operative infections.CONCLUSIONS Patients who undergo DCL with packing have a high incidence of postoperative infections.Pathogens and distribution are same as acquired infections.Pre-existing abdominal infection and increased number of surgical procedures are the independent risk factors for postoperative infections in these patients.