A study of occurrence of intra-abdominal sepsis after emergency abdominal surgery at tertiary health care
Journal Title: Medpulse International Journal of Surgery - Year 2017, Vol 4, Issue 2
Abstract
Background: One of the most common intra-abdominal sepsis after emergency abdominal surgeries is Surgical Site infections (SSIs). Aims and Objectives: To Study occurrence of intraabdominal sepsis after emergency abdominal surgery at tertiary health care. Methodology: This Prospective study was carried out in Jan 2015 – June 2016 at Department of Surgery, Vinayaka Missions Kirupanada Variyar Medical College and Hospital Salem in 50 cases of emergency abdominal surgery. All the questionnaires were coded and the collected data entered into the computer using SPSS version 20 for analysis. Descriptive statistical test like mean and standard deviation were derived for all parametric variables. In addition, the standard normal deviate test was used to make comparisons where appropriate. Association between intrabdominal sepsis post-operatively and the operative characteristics were calculated using univariate logistic analysis. Results were presented in forms of tables, graphs and diagrams. Result: Majority of the study subjects were in the age group of between 20 and 40 years and the mean age was 38.1 years. The male: female ratio is 2.3: 1 i.e. 70% of them were males and 30% are females. 70% of the patients had developed intra-abdominal sepsis after the surgery.Most common form of intra-abdominal sepsis which had occurred among the patients was surgical site infection followed by drain point site infection. The commonest microorganism detected was staphylococcus aureus followed by E.cloli and klebsiella. Surgical site infection was significantly associated with appendicectomy, duodenal perforation and mesh infection (P<0.05), Increase in the duration of surgery, post -operative period of 7 – 10, The post-operative abdominal sepsis like anastomosis dehiscence, drain site infection and mesh infection were more common as the age increases and the surgical site infection was found to be more common in younger age group and this association was found to be statistically significant (p<.05). Similarly in younger age group the incidence of intra-abdominal sepsis was found to be less common and the association was found to be statistically significant (p<.05). Conclusion: The causes for the sepsis might include the ward environment, contaminated theatre and patients low immunity status and non-adherence aseptic techniques both in the theatres and the wards. An emergency abdominal surgery poses a great risk to developing intra-abdominal sepsis and as such surgeons should enforce the use of prophylactic antibiotics in the peri-operative period. Prescribing full course of antibiotics in the post-operative period is unjustified.
Authors and Affiliations
Vijaykrishna Patil, Prashant Harsur
Keywords
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