Bacterial density in laparotomy wounds during gastro-instestinal operations
Raahave, D.
Scandinavian Journal of Gastroenterology. Supplement 37: 135-142
1976
ISSN/ISBN: 0085-5928 PMID: 775616 Document Number: 106842
Operation wounds were sampled quantitatively for aerobic bacteria in 56 patients by the velvet pad rinse technique in a prospective, random study of abdominal operations: truncal vagotomy and pyloroplasty, gastric or colo-rectal operations, and exploratory laparotomy. On entering the peritoneal cavity and prior to incision of the gastro-intestinal tract the bacterial density in the wounds did not differ significantly between these 4 types of operations, the median being 5.4 .times. 10-1 viable counts/cm2 (range 0.7-135.8). In all operations the median bacterial density was increased prior to closure of the wounds, significantly so after colo-rectal operations, being 21.3 .times. 10-1 viable counts/cm2 (range 1.1-144.4), caused by a rise in density of aerobic intestinal species, especially Escherichia coli. Regardless of type of operation, all wounds were contaminated during operation by aerobic commensals of the skin and mucous membranes of the upper respiratory tract, in particular by Staphylococcus epidermidis, this species not differing significantly in density from the beginning to the end of operation. Within the operation wound, sites of low or even 0 bacterial density were close to sites with a high density. Postoperative wound infection is apparently closely related to the density of the different species of bacteria present in the operation wound at closure.