PURPOSE: Many investigators reported the advantage of laparoscopic colorectal surgery for prevention of surgical site infection (SSI). To compare wound bacterial contamination between open colorectal surgery (OC) and laparoscopic colorectal surgery (LC).
METHOD: Colorectal cancer surgery with no association of ileus was evaluated between 22 OC cases and 19 LC cases. Preoperatively, only mechanical preparation was applied. And second generation cephalosporins were administered right before the operation. Soon after the surgery, wound irrigation was performed utilizing 500ml warm saline. Subsequently, 10ml saline was irrigated and extracted to determine viable count. The count below 20 CFU/ml was determined to be gundetectedh.
RESULTS: Backgrounds were similar between two groups. The bacterial detection rate before irrigation was 5/21 cases (24%) in OC and 6/19cases (32%) in LC; no difference was found in detection rate. In addition, the rate after irrigation with 500ml warm saline was 2/21 cases (10%) in OC and 1/19 cases (5%) in LC; no difference. In open group, detected bacteria were aerobic Bacillus sp., anaerobic Bacteroides and anerobic gram-positive Bacillus that was detected even after the irrigation. In LC, detected bacteria were aerobic Enterococcus and anaerobic gram-positive Bacillus that was detected even after the irrigation. Clinically, one wound infection was found in OC comparing to no wound infection in LC. Each group has one case of intraabdominal abscess.
DISCUSSION: In colorectal cancer surgery, LC demonstrated high incidence of wound contamination than OC, but LC seems to have advantage in wound infection. Some immunological advantage in LC suggested for prevention of surgical site infection (SSI), In this study, however, wound irrigation after both open and laparoscopic surgery proved higher effectiveness.
Program Number: P131