Source of infection in postcholecystectomy wound sepsis

ABSTRACT

A prospective bacteriological study was carried out on 212 patients undergoing elective cholecystectomy to identify and compare bacteria from bile and septic wounds. Bacteria were isolated from the bile in 43 patients [20%] 28 patients [13%] developed post-operative wound sepsis. Of 28 patients 20 [71%] with wound infection had positive bile culture. Of those 20 patients, 16 [80%] with wound sepsis and positive bile culture were found to have the same organisms in both bile and wound. Escherichia coli was the commonest organism isolated from both bile and septic wounds. Anaerobic organisms were isolated from the bile of two patients and from infected wound in only one patient. Cholecystectomy with duct exploration was associated with an incidence of wound infection as compared with cholecystectomy alone. A non-functioning gall bladder and operative cholangiography were not demonstrable risks in our series. The sensitivity of organisms recovered from bile to various antibiotics was assessed. The use of prophylactic antibiotics preferably as per-operative single doses in elective cholecystectomy is recommended