Prophylaxis of infection in region of the surgical intervention performance in laparoscopic cholecystectomy

Keywords: laparoscopic cholecystectomy; infection of region of surgical intervention; the wound protector.

Abstract

Objective. To estimate the efficacy of prophylactic method for regional infection while performance of laparoscopic cholecystectomy, using simultaneous application of container for removal of the specimen and a two-ring wound protector of the wound. In accordance to the literature data, the infection rate in laparoscopic cholecystectomy conduction constitutes 2.4 - 9.6%.

Materials and methods. The work was based on experience of performance of 759 laparoscopic cholecystectomies during the period of 2015 - 2018 yrs. There were performed 679 operations with the second class of microbial contamination, 17 - with the third one and 6 - with the fourth. In 21 patients the conversion into laparotomy was applied. The patients with third and fourth classes of microbial contamination of wounds were divided into two groups: the first - 61 patients, in whom a container was used for the specimen removal, and the second - 19 patients, in whom the method of combined application of container and the wound protector was applied for removal of the specimen.

Results. Infection of region of the surgical intervention performance in laparoscopic cholecystectomy was revealed in 41 (5.40%) of 759 patients.In surgical interventions In surgical interventions, referring to second class of microbial contamination , the infection rate in the surgical intervention region have constituted 2,5%, while referring to the third class - 11.76%, and the fourth class - 34.92%. Conversion in laparoscopic cholecystectomy is accompanied with high rate of the wound infection - 38.09%.

Conclusion. Application of the method of combined usage of container for removal of preparation and a two-ring protector of the wound in the third and the fourth classes of the wounds while performance of laparoscopic cholecystectomy have permitted to lower the infection rate in region of the surgical intervention performance from 37.70 to 5.26%.

Author Biographies

V. V. Kryzhevskii, Shupyk Medical Academy of Postgraduate Education, Kyiv

Kryzhevskii Vadym V. - MD, DSci(Med), Associate Professor,
Head of the Department of General and Emergency Surgery
Shupyk National Medical Academy of Postgraduate Education,
Head of Kiev City Hospital Nr 6.
3 Kyiv, Komarov Ave, 03065, Kyiv, Ukraine,.
+38044-408 2390.
medgorodok.kmkl6@gmail.com
http://orcid.org/0000-0002-8538-2583

N. A. Mendel, Medical Centre «Oberig», Kyiv

Mendel Mykola A.- MD, PhD(Med),
Head of the Department of General and Abdominal Surgery
Medical Center "Oberig".
3 Zoologichna Str, corpus «B», 03057, Ukraine, Kyiv,
+380-50-469-6221.
nickmendel1@gmail.com
http://orcid.org/0000-0001-9507-7817

A. P. Brodskaya, Shupyk Medical Academy of Postgraduate Education, Kyiv

Brodskaya Anna P., MD, graduate student
Department of General and Emergency Surgery
Shupyk National Medical Academy of Postgraduate Education
3Komarov Ave, 03065, Ukraine, Kyiv,
38044-408 2390.
anna0992766303@gmail.com
https://orcid.org/0000-0001-6278-8268

Yu. V. Pavlovych, Shupyk Medical Academy of Postgraduate Education, Kyiv

Pavlovych Yuliia V. - MD, graduate student
Department of General and Emergency Surgery
Shupyk National Medical Academy of Postgraduate Education
Surgeon in the Medical Center "Oberig".
9 Dorogozhytska Str, 04112, Ukraine, Kyiv,
+380-97-638-5274.
ssolnushko@gmail.com
https://orcid.org/0000-0002-3516-0907

References

Comajuncosas J, Hermoso J, Jimeno J, Gris P, Orbeal R, Cruz A, et al. Effect of bag extraction to prevent wound infection on umbilical port site wound on elective laparoscopic cholecystectomy: a prospective randomised clinical trial. Surg Endosc. 2017;31(1):249-54. doi: 10.1007/s00464-016-4965-z.

La Regina D, Mongelli F, Cafarotti S, Saporito A, Ceppi M, Di Giuseppe M, et al. Use of retrieval bag in the prevention of wound infection in elective laparoscopic cholecystectomy: is it evidence-based? A meta-analysis. BMC Surg. 201819;18(1):102. doi: 10.1186/s12893-018-0442-z.

Majid MH, Meshkat B, Kohar H, El Masry S. Specimen retrieval during elective laparoscopic cholecystectomy: is it safe not to use a retrieval bag? BMC Surg. 2016;16(1):64. doi: 10.1186/s12893-016-0181-y.

Global Guidelines for the Prevention of Surgical Site Infection. [Internet]. Geneva: World Health Organization; 2018. 185 p. Available from: https://www.who.int/infection-prevention/publications/ssi-prevention-guidelines/en/ . ISBN 978-92-4-155047-5.

Briko NI, Bozhkova SA, Brusina EB, Zhedaeva MV, Zubareva NA, Zueva LP, et al. Profilaktika infektsiy oblasti hirurgicheskogo vmeshatelstva. Klinicheskie rekomendatsii. Nizhniy Novgorod: Remedium Privolzhe; 2018. 72 s. ISBN 978-5-906125-53-8. [In Russian].

Zinn JL. Surgical wound classification: communication is needed for accuracy. AORN J. 2012;95(2):274-8. doi: 10.1016/j.aorn.2011.10.013.

Kryzhevskyi VV, Mendel MA, Pavlovych YuV, Brodska AP, vynakhidnyky; Shupyk National Medical Academy of Postgraduate Education, patentovlasnyk. Sposib profilaktyky infikuvannia troakarnoi rany pry laparoskopichnykh operatsiiakh. Patent Ukrainy 136045. 2019 Lyp 7. [In Ukrainian].

Bilyayeva OO, Korzhyk N P, Myronov OM, Yemets VV, Miroshnychenko AP, Bilyayev VV. Cholelithiasis: complications and rehabilitation. Klin khir. 2014;(11):32-43. PMID: 25675740. [In Ukrainian].

Published
2020-06-26
How to Cite
Kryzhevskii, V. V., Mendel, N. A., Brodskaya, A. P., & Pavlovych, Y. V. (2020). Prophylaxis of infection in region of the surgical intervention performance in laparoscopic cholecystectomy. Klinicheskaia Khirurgiia, 87(3-4), 22-25. https://doi.org/10.26779/2522-1396.2020.3-4.22
Section
General Problems of Surgery