Audit of sepsis in operations for inflammatory bowel disease

Publisher Website
Google Scholar
Abstract
The results of a prospective audit of the rates of postoperative infection in patients having operations for inflammatory bowel disease are reported. Apart from a single prospective controlled trial, all other groups were studied sequentially using the original placebo control group for comparison. The rate of abdominal wound sepsis when no antibiotic was used was 37%. This was reduced to 23.3% with 24-h cover using metronidazole and gentamicin. However, only after prolonged use of metronidazole and gentamicin for 5 days was there a significant reduction in abdominal wound infections to 13.3%. Prophylaxis, using 24-h cover with metronidazole combined with 5-day therapy with mezlocillin, achieved an abdominal wound infection rate of 15.6%. The most recent group of patients studied have received 24-h cover with metronidazole and 5-day exposure to latamoxef. In the last group the rate of abdominal wound infections was only 13.5% and serious postoperative bleeding was recorded in 8 patients (15%) compared with serious bleeding in only 3 of the remaining 129 patients (2.3%). The only patients in whom streptococcal isolates were eliminated were those receiving metronidazole and mezlocillin. The majority of infections was due to antibiotic-sensitive strains of Escherichia coli, Proteus and Staphylococcus species.