Predictive value of bacterial analysis of laparotomy wounds

ACKGROUND:Despite improvements in antibiotic prophylaxis, surgical site infections represent the most common post-operative complication with important clinical consequences for patients.AIM:The hypothesis that a bacterial analysis of the surgical wound in the operating room could predict the likelihoodof developing a clinical infection, and might allow a tailored and preemptive approach, aimed to reduce the consequencesof an infection, seems appealing. We would like to present a prospective study on the predictive value of the bacterialanalysis of laparotomy wounds.MATERIAL OFSTUDY:Seventy eight prospective patients undergoing surgery were included in the study. To evaluate therisk factors associated with increased rate of wound infection, we performed a bacterial analysis of the wound.RESULTS: 48 patients out of 78 (61%) had positive cultures. 23 patients out of 32 patients (72%) who didn’t receiveantibiotic prophylaxis were positive to the wound culture whereas 25 patients out of 46 patients (54%) grew positivecultures in the group of patients that received antibiotic prophylaxis. None of the 30 patients with negative culturesdeveloped clinical infection. Only 6 patients out of 48 patients who had positive cultures (12.5%) developed woundinfection. Clinical infection occurred in 5 patients who had gram-negative contamination of the wound. No clinicalinfection occurred in patients who had gram-positive contamination.CONCLUSION:Wound cultures and their positivity are predictive tools to identify the patients that are at risk to devel-op wound infection. The positive predictive value of the bacterial analysis of the wound was 12.5%.