Infections following damage control laparotomy with abdominal packing

Scand J Infect Dis. 2008;40(11-12):867-76. doi: 10.1080/00365540802262109.

Abstract

Our objective was to describe postoperative infections for patients undergoing damage control laparotomy (DCL) with abdominal packing. We retrospectively reviewed data on packing patients in Jinling hospital (China) during a 5-y period. Of 26 patients, 15 (57.7%) had postoperative infections. Pneumonia/lower respiratory tract infection (57.7%), bacteraemia (50%), and urinary tract infection (15.4%) were the 3 prominent types of infections. The most frequently isolated bacteria were Pseudomonas aeruginosa (20.7%), staphylococcal species (15.6%), Acinetobacter baumannii (13.9%), and Klebsiella species (11.1%). Antibiotic resistance was common both for the Gram-positive and Gram-negative isolates. No statistical correlation was demonstrated between positive packs and postoperative infection (p=0.10) or death (p=1.00). Multivariate regression analysis revealed pre-existing abdominal infection (OR=22.4, p=0.02) and increased number of surgical procedures (OR=3.69, p=0.05) to be independent risk factors for postoperative de novo infection. We conclude that patients undergoing DCL with packing carry a high incidence of postoperative infections. Causative pathogens are typical for ICU acquired infections and are often associated with low levels of susceptibility to multiple antimicrobial agents. Pre-existing abdominal infection and increased number of surgical procedures are the independent risk factors for postoperative de novo infection in these patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdomen / surgery*
  • Abdominal Injuries / surgery*
  • Adolescent
  • Adult
  • Aged
  • Bacterial Infections / drug therapy
  • Bacterial Infections / etiology*
  • Bacterial Infections / microbiology
  • Female
  • Hemorrhage / surgery*
  • Humans
  • Male
  • Middle Aged
  • Peritonitis
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology*
  • Postoperative Complications / microbiology
  • Retrospective Studies
  • Risk Factors