Wound infection following laryngectomy. The effect of topical ampicillin and carbenicillin.

A study of twenty-two consecutive laryngectomies performed in one unit is reported. In eleven controls, seven (67%) developed a wound infection. In eleven patients, IG of Ampicillin and IG of Carbenicillin were used topically, and three (18%) developed a wound infection (P less than 0-04). Studies of the bacterial flora at the time of operation suggest that the major source of wound contamination is colonization of the upper gastrointestinal and respiratory tract. The ease with which a small innoculum of pathogens produces wound infection in these patients is discussed, and it is suggested that the underlying defect is depression of host cellular immunity resulting in failure of bacterial destruction by activated macrophages.