| Abstract [eng] |
Surgical site infections are among the most common postoperative complications, particularly following gastrointestinal surgery. Although microbiological contamination of the wound may contribute to the development of infections, its prognostic value remains unclear. Aim. To determine whether intraoperative microbiological contamination of the surgical wound is associated with the development of surgical site infections. Objectives: (I) to determine the incidence of intraoperative wound contamination and surgical site infections in patients undergoing gastrointestinal surgery; (II) to evaluate the association between intraoperative microbiological contamination and the development of surgical site infections; (III) to identify the spectrum of microorganisms isolated from intraoperative wound cultures and compare it with those identified in surgical site infections; (IV) to review the available literature on the relationship between intraoperative wound contamination and surgical site infections and compare it with the findings of this study. Methods. A prospective longitudinal observational study was conducted including 110 patients who underwent major abdominal resection procedures for neoplastic pathologies. To evaluate intraoperative wound contamination, surgical wound samples were collected with a sterile swab at the end of the operation, after aponeurosis closure and before skin closure. Following surgery, patients were monitored for 30 days for the development of surgical site infections. Upon diagnosis of a surgical site infection, samples from the infection site were collected using a sterile syringe and analyzed by microbiological culture methods. A literature review was also performed. Results. Postoperative complications occurred in 49 out of the 110 patients (45 %), including surgical site infections (SSIs) in 25 patients (23 %). Patients who developed SSIs had a significantly more advanced pathological tumor stage, a higher incidence of regional lymph node metastases (pN), and were more likely to undergo open surgery compared to patients without SSIs. Intraoperative wound cultures obtained at the end of surgery were positive in 36 patients (33 %). Although superficial SSIs were more frequently observed in patients with positive intraoperative cultures, this difference was not statistically significant (p = 0,150). The most commonly identified microorganism in positive intraoperative cultures was Escherichia coli (53 %). Among patients who developed superficial SSIs, microorganisms identified in intraoperative cultures were fully covered by preoperative antibiotic prophylaxis in 33 % of cases. Of the 6 patients in whom microbial growth was detected in both intraoperative and SSI cultures, partial concordance was identified in 5 cases (83 %). Conclusions: Intraoperative wound contamination was not significantly associated with the incidence of surgical site infections in the study population. |
