Risk Factors for Surgical Wound Infection After Elective Laparoscopic Cholecystectomy

Abstract

BACKGROUND: One of the ways to avoid infection after surgical procedures is through antibiotic prophylaxis. This occurs in cholecystectomies with certain risk factors for infection. However, some guidelines suggest the use of antibiotic prophylaxis for all cholecystectomies, although current evidence does not indicate any advantage of this practice in the absence of risk factors. AIMS: This study aims to evaluate the incidence of wound infection after elective laparoscopic cholecystectomies and the use of antibiotic prophylaxis in these procedures. METHODS: This is a retrospective study of 439 patients with chronic cholecystitis and cholelithiasis, accounting for different risk factors for wound infection. RESULTS: There were seven cases of wound infection (1.59%). No antibiotic prophylaxis regimen significantly altered infection rates. There was a statistically significant correlation between wound infection and male patients (p=0.013). No other analyzed risk factor showed a statistical correlation with wound infection. CONCLUSIONS: The nonuse of antibiotic prophylaxis and other analyzed factors did not present a significant correlation for the increase in the occurrence of wound infection. Studies with a larger sample and a control group without antibiotic prophylaxis are necessary.

Revisión bibliográfica: Infección de herida quirúrgica: profilaxis y tratamiento

“…Para realizar un procedimiento quirúrgico es necesario determinar si el paciente está en condiciones óptimas para ser interviniendo quirúrgicamente, estos indicadores se mantienen durante todo el proceso peri operatorio con el objetivo de realizar una cirugía segura y evitar complicaciones (Macías,2022), los parámetros que se evalúan son tiempo de ingreso, realización de profilaxis antimicrobianas 24 horas antes o por los menos 30 a 60 minutos antes de la incisión, para maximizar la concentración de antibióticos en los tejidos, realización del procedimiento de antisepsia del campo operatorio y control del nivel de glucemia postoperatoria en los pacientes que tengan diabetes siendo esto un factor de riesgo (Gamo et al, 2022;Guo et al,2022). ISSN en línea: 2789-3855, marzo, 2023, Volumen 4, Número 1, p. 2586.…”

Bile Duct Injury Repair in a Patient With Situs Inversus Totalis

“…This can avoid performing the hepaticojejunostomy in an ischemic portion of the common bile duct, or in a portion with thermal injury or fibrotic tissue, and therefore, prevent the failure of the anastomosis. It has already been demonstrated that on-table repair by non-HPB specialists appears to be an independent risk factor for biliary strictures, recurrent cholangitis, revision surgery, and overall morbidity 9 , 19 . On the other hand, early referral can decrease the incidence of strictures and postoperative complications 27 , as well as the risk of litigation 2 .…”

Antibiotic Prophylaxis for Abdominal Surgery: When to Recommend? Brazilian College of Digestive Surgery Position Paper

“…Oral antimicrobials are commonly administered alongside bowel preparation, which is a highly debated topic in the literature. Major perioperative care protocols such as Enhanced Recovery After Surgery and Acerto recommend limiting bowel preparation 6 , 19 , 24 , 26 . The rationale behind this is to reduce hydroelectrolytic imbalance and the need for intravenous fluids during the perioperative period 24 , 26 .…”

“…Major perioperative care protocols such as Enhanced Recovery After Surgery and Acerto recommend limiting bowel preparation 6 , 19 , 24 , 26 . The rationale behind this is to reduce hydroelectrolytic imbalance and the need for intravenous fluids during the perioperative period 24 , 26 . The concept of no bowel preparation in elective colorectal surgery is supported by a randomized trial from Finland (MOBILE trial), which showed no difference in terms of SSIs and overall morbidity between mechanical bowel preparation, oral antibiotic bowel preparation, and no bowel preparation 32 .…”