Prevention of port site infection after laparoscopic cholecystectomy for acute destructive cholecystitis in patients with I—II degree obesity

2019 ◽  
Vol 0 (4) ◽  
pp. 16-20
Author(s):  
R. V. Bondariev ◽  
O. I. Sopko ◽  
R. M. Kozubovich ◽  
V. M. Ivantsok ◽  
O. O. Bondarieva
2021 ◽  
Vol 28 (03) ◽  
pp. 277-281
Author(s):  
Bushra Shaikh ◽  
Imamuddin Baloch ◽  
Azhar Ali Shah ◽  
Abdul Sami Mirani ◽  
Parkash Lal Lund ◽  
...  

Objective: To compare the frequency of port site wound infection following gall bladder removal through umbilical and epigastric port in laparoscopic cholecystectomy. Study Design: Randomized Control Trial. Setting: Surgical Unit 2, Ghulam Muhammad Mahar Medical College, hospital Sukkur. Period: 1st November 2019 to 30th October 2020. Material & Methods: All cases who underwent four port laparoscopic cholecystectomy were enrolled in two groups. All procedures were performed under general anesthesia. As the last event of surgery gall bladder was retrieved in a glove bag through umbilical port in group A and through epigastric port in group B, both under direct camera vision. Wound infection was considered if there was 3 to 5 grade of wound according to Southampton wound grading system (Figure-1) on 5th postoperative day. All demographics and outcome variables were recorded. Results: Age ranged from 20 to 60 years with mean age of 38.875±8.11 years, BMI 29.973±5.12 Kg/m2, duration of surgery 50.656±8.41 mins and Southampton score was 1.044±1.07 in Group A and mean age of 38.560±6.23 years, BMI 27.437±5.04 Kg/m2, duration of surgery 48.920±8.67 mins and Southampton score was 0.856±0.92 in Group B. In group A, 18 (5.7%)patients developed port site wound infection in contrast to 5 (1.6%) patients in group B (P= 0.006). Conclusion: We conclude that epigastric port retrieval of gall bladder following laparoscopic cholecystectomy results in less port site infection.


2020 ◽  
Vol 27 (08) ◽  
pp. 1717-1721
Author(s):  
Ehsanullah Malik ◽  
Sania Bhatti ◽  
Muharram Ali Abbasi ◽  
Yasmeen Bhatti ◽  
Abdul Sattar Abro ◽  
...  

Laparoscopic cholecystectomy is a gold standard procedure for the management of patients with cholelithiasis with fewer complications but still port site hernia is one of the severe complications if not treated properly may lead adverse result. This usually results from improper closure or infection of the musculoaponeurotic layers of the abdominal wall. The frequency of port site hernia is variable in literature and its association with infection and other co-morbidities is less explored. Objectives: To determine the frequency of port-site hernia after laparoscopic cholecystectomy at a tertiary care hospital Larkana and its association with infection and co-morbidities. Study Design: Descriptive Case Series study. Setting: Department of Surgery, Chandka Medical College Teaching Hospital, Larkana. Period: December 2018 to December 2019. Material & Methods: One hundred forty-eight patients undergoing elective laparoscopic cholecystectomies, who fulfilled the inclusion criteria and gave informed consent were selected for this study. All the patients were followed for 6 months. Data was recorded for age, gender, BMI, smoking and diabetes mellitus status. Infection and port site hernia were observed during the follow-up period. The SPSS version 21 was used for data analysis. Results: The majority of the patients 79 (53.4%) were above the age of 35 years. The mean age of the patients was 40.14 ±11.40 years. Females were younger than males. Among them 19 (12.8%) were males compared to 129 (87.2%) females. Mean BMI (kg/m2) of male patients were 25.98±3.53 and female patients were 24.80±3.04. The mean duration of surgery was 63.72 (+18.20) minutes, mostly accomplished is within 80mins (54.1%).  Out of 148 patients in 5 (3.4%) patients port site hernia was observed. In all these patients wound to get infected and surgery was for a prolonged period. A significant association has been found between port site hernia, operative time and port site infection. However, no significant association has been found between port site hernia and gender, age, smoking and Diabetes (P>0.05). Conclusion: The frequency of port site hernia is low but could be disastrous if the bowel gets obstructed. Using good technique and reducing operative time are effective measures in reducing the port site infection and the port site hernia.


2021 ◽  
Vol 8 (2) ◽  
pp. 760
Author(s):  
Devajit Chowlek Shyam ◽  
Ranjit Chowlek Shyam ◽  
Donkupar Khongwar ◽  
Dathiadiam Tongper

Gallstone disease is one of the most common gastrointestinal conditions requiring surgery and more than 90% of cholecystectomies are done laparoscopically. The major complications of laparoscopic cholecystectomy are major bleeding, Bile duct injury, and wound infection or surgical site infection. The incidence of Surgical site infection in laparoscopic cholecystectomy (0.4-1.13%) is significantly low compared to open cholecystectomy (3-47%) and the probable reasons are the smaller incision and the use of trocar along with almost nil to minimal wound contamination as compared to open cholecystectomy. Port site infection is a type of surgical site infection (1.8%) and the Umbilical port site is the most common site followed by the epigastric port site. In spite of the low-risk of surgical site infection, many surgeons still practice antibiotic prophylaxis in elective laparoscopic cholecystectomy for low-risk patients. Antibiotic prophylaxis is a debatable topic in the low-risk group undergoing elective laparoscopic cholecystectomy.Meticulous preoperative skin preparation is one of the established local factors to prevent the occurrence of SSI.


2017 ◽  
Vol 24 (4) ◽  
pp. 221-223
Author(s):  
Şükrü Taş ◽  
Ömer Faruk Özkan ◽  
Aslı Kiraz ◽  
Umut Ercan ◽  
Yılmaz Akgün

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Adnan ◽  
S Sange ◽  
M Ahmed ◽  
S Kanchustambam

Abstract Introduction Approximately 8% of patients who undergo laparoscopic surgery develop port site infections1. This would negatively impact recovery and increase rates of readmission. Patients’ skin is a major source of pathogens that results in surgical site infection (SSI). Therefore, optimisation of antiseptic skin preparations may decrease postoperative umbilical port site infection (UPSI). Method A retrospective analysis of 226 cases from August 2019 till October 2020 at East Lancashire Hospital NHS Trust was performed. The first cycle included 122 patients (58 cholecystectomies and 64 appendicectomies), and a further 104 patients (51 cholecystectomies and 53 appendicectomies) after emphasising on using chlorhexidine pink as skin preparation. The presence of UPSIs within 30 days post-surgery was recorded. Results In the first cycle, the local preparation that was used in patients with UPSI was chlorhexidine pink (21.4%) and betadine (78.6%). The surgical team were then educated regarding the benefits of chlorhexidine pink over betadine as local skin preparation. In the second cycle, 63.3% used chlorhexidine pink and 36.7% used betadine. After the above implementation, there was a reduction in the rate of UPSI (18.0% to 15.7%) and readmission rates (7.2% to 5.9%) in patients who had undergone laparoscopic cholecystectomy. In patients who had undergone laparoscopic appendicectomy, a similar trend in UPSI rates was identified as well (7.1% to 5.5%) and readmission rates (5.5% to 1.9%). Conclusions The incidence of UPSI was reduced with the use of chlorhexidine pink compared to betadine. This may have contributed to the decrease in UPSI cases and led to a reduction in re-admission rates.


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