A Study on the Sourcees of Postoperative Wound Infection in Patients with Open Fracture / 대한정형외과학회잡지

ABSTRACT

The purpose of this paper is to define the bacterial sources of wound infection after surgery including debridement for open fractures. Total number of patients were 123 during surgery July 1975 to Oct. 1976 at Hangang Sacred Heart Hospital. Out of 123 cases 17 were infected postoperatively. Serial bacterial cultures were performed for specimens taken from the contaminated wound in emergency room and by exposing the Petri-dishes in the operating room. Additional cultures were carried out for 17 specimens taken from the infected wounds postoperatively. Positive bacterial cultures from the initial wounds were obtained in 71 cases (57.7%) out of 123 contaminated wounds in emergency room. Setting monitoring of air contamination in conventional operating room, 51 colonies of bacterial growth per 1 hour exposure were noted and common organisms were colliform bacilli, streptococci and staphylococci in order. Postoperative wound infection rate was 13. 8%. Common pathogens were staphylococcus aureus, coliform bacilli and pseudomonas and kanamycin was most effective antibiotics. The retrospective bacteriological studies for 17 infected cases elucidated following results: 1) Organisms of same species; from initial wound and infected wound postoperatively 7 cases 2) Organisms of same species; from air contamination in the operating room and infectected wound postoperatiyely 5 cases 3) Organism of same species; from air contamination in the operating room, initial wound and infected wound postoperatively 1 case 4) Others (contagious or endogenous origin) 4 cases The results reveal that the initial contaminated open fracture and air contamination during surgery are the main sources of postoperative infection. Four cases which the infectious sources were not determined included in contagious origin dogmaticaIly.