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A prospective study on Intraperitoneal antibiotic Lavage for trauma patient undergoing Laparotomies to reduce incidence of infection

Author: 
Dr. Krishna Prasad, K., Dr. Arvind Ramachandran, Dr. Praveen, G. P. and Dr. Amal Abraham
Subject Area: 
Health Sciences
Abstract: 

Background: Preoperative antibiotics for elective abdominal operations are essential in decreasing surgical site infections such that the timely and appropriate administration of antimicrobials is a quality benchmark measure. However, their role in emergent surgery for intestinal perforation is controversial. In the pre antibiotic era, penetrating abdominal trauma was associated with a mortality rate as high as 65% to 70%. 1 Methods: A prospective study compared using either 500 mg of intraperitoneal metronidazole or a saline control in 30 adult trauma patients requiring diagnostic peritoneal lavage was conducted over a 2 month period. Two groups were made Group A ¬ received metronidazole and Group B the saline wash. Result: In this prospective study comprising of 30 adults who underwent laparotomy, patients were randomised and assigned into group A and group B by odd even method. Group A consisted of 15 patients in whom diagnostic peritoneal lavage was performed using 500mg of metronidazole and group B consisted of 15 patients in whom diagnostic peritoneal lavage was performed using saline only. Septicemia evidence by presence of fever and tachycardia was noted in 8 out of the 15 patients of group B and 3 out of the 15 patients in group A comprising 53.3% and 20% of each group respectively. Wound dehiscence was seen i one patient of each group. Overall group A patients who received DPL with metronidazole 500 mg as compared to normal saline as DPL has lesser incidence of postoperative complication, shorter duration of hospital stay and lesser incidence of septic complication.

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