Publication

Abstract : Emergency abdominal surgeries entail different types of clinical entities that need be operated on emergency basis. Such entities show wide variations locally as well as globally1. Several of such emergency abdominal surgeries go on to develop Surgical Site Infections (SSIs) leading to post-operative complications of serious concern causing considerable morbidity and mortality2. These SSIs are, broadly, placed under nosocomial infections category and account for approximately 10-40% of all health care associated (HAI) infections1-4. Since the clinical picture and surgical entities exhibit variations, therefore the aim of the study was to estimate the frequencies of different types of clinical entities and their presentations’ variations along with the elucidation of the types of potentially pathogenic bacteria, in adult patients who have undergone emergency abdominal surgery as well as elective. The present study was carried out in the department of Microbiology, VMMC & Safdarjang hospital, New Delhi from November, 2015 to January, 2017. A total of 50 cases that developed the SSIs were selected as per CDC criteria for wound selection. Ileal perforation peritonitis emerged as the major clinical entity followed by duodenal ulcer perforation. Clinically, pus discharge was the most important sign followed by abdominal pain & fever (24%). Among signs, abdominal guarding was followed by abdominal distension and decreased bowel sounds (4%). E. coli was the most common isolate followed by Klebsiella pneumoniae. Among gram positive - Staphylococcus aureus emerged as the most common isolate. Awareness in any given institution, whether large or small, about the most common clinical entities and their clinical presentations helps surgeons to be better prepared to handle the emergency situations. Along with this, awareness additional information about the likely underlying potential bacterial pathogen helps surgeon to initiate the right kind of antimicrobial empirical therapy in a timely manner so that the morbidity and mortality reduction due to SSIs can be reduced as much as possible. Such studies need be carried out, at least, on periodic basis to assess the changes and introduce modifications in policy management on SSIs.