Wound infections in abdominal surgery. A prospective study on 696 operations.

A prospective analysis of wound infections in abdominal surgery was carried out in the Department of Surgery, University of Turku, during two 3-month periods. Excluding vascular and urologic surgery altogether 696 abdominal operations were performed. The overall wound infection rate was 9.8%. According to the wound classification the rates of wound infection were the following: clean wounds 4.2%, clean contaminated 9.1%, contaminated 14.4%, and dirty wounds 28.8%. Factors promoting wound infection rate included high age of the patient, associated medical illnesses, prolonged preoperative hospitalization, prolonged duration or extensiveness of the procedure, and missing peritoneal lavage in patients with peritonitis, intestinal strangulation or gross abdominal contamination. The infection rate in acute surgery (12.4%) was higher than that in elective procedures (7.6%). S. aureus was the most common bacteria in wound infections after clean surgery while E. coli dominated in cultures from infected wounds after contaminated surgery. Patients with wound infection were prome to develop other postoperative infections and lung atelectases. The mean nursing time of patients with wound infection was 7 days longer than in uninfected patients. Mortality in patients without wound infections was 1.6% and in patients with wound infection 11.8%.