INCIDENCE OF SURGICAL WOUND INFECTION IN PATIENTSRECEIVING PERIOPERATIVE ANTIBIOTICSDr. HIWA OMER AHMED MB.CHB.CABS.consultant surgeon & lecturer in college of MedicineUniversity of Sulaimani ABSTRACT Most of the surgical wounds according to the type of the operations , are at riskof contamination either from endogenous or exogenous sources . This contaminationis multifactorial , there are some well known methodes to decrease the rate ofcontamination & concomitant wound infection . In this paper we tried to evaluatethe role of perioperative antibiotics in decreasing the rate of surgical woundinfection . And we found this regimn to be safe , costeffective and decreasingwound infection , hospital stay , morbidity and mortality . INTRODUCTION: Large number of surgical patients will become infected before , during or afterthe operations , either from endogenous flora of the gut , respiratory tract andskin or from exogenous airborn dust which carries bacteria derived from skinorganism of attendants and operative personnels ( 1 ).For any wound the most important priority is to avoid the development to infection( 2 ).The wound infection will increase morbidity , inpatient stay , cost and mortalityof the surgical patients , now it is clear that administering perioperativeantibiotics will decrease the incidence of wound infection ( 3 ) and it’sconcomitant complications by three folds ( 4 ) .

PAITIENTS & METHOD: This paper is a prospective study from 1st March 1993 to 1st March 1997 , inSulaimani teaching hospital of 328 beds , including 500 patients who haveundergone different types of urgent and elective surgical operations . Fourhundred and twenty cases were elective and the rest were urgent .All of them either underwent potentially contaminated (clear contaminated)or contaminated operations as shown in table I . Table : I showing number & percentage of the type of the operations Type of the operationsNumber% 1. Clean contaminatedLike - cholecystectomy- Hysterectomy.... etc2. Contaminated like- colectomy , gastrectomy- cholecystectomy in presence ofinfected bile ( 5 ) 400 10080 20 All the patients recieved perioperative antibiotics according to the policy nowthe most widely adopted for 3 doses; first intravenously with the induction of theanaesthesia , secound during the operation and third dose within 8 hours after theoperation.

We obliged in some cases, to continue same antibiotics, according to thierpathological conditions, for 3 days postoperatively as shown in table IITable II : showing number of doses & duration of the antibiotic courses : Dose & durationNomber of patients% 3 perioperative doses.3 perioperative doses + for 3 days.40397 80.619.4 Antibiotics, which were used in our regimn shown in, table III Table III: showing perioperative antibiotics AntibioticsNumber of patients Ampicillin + GentamicinAmpicillin + Gentamicin + Metronidasole.360140 The incidence of wound infection in the patients who recieved perioperativeantibiotics was 5.6% (28 patients), while in a control group of patients notrecieving perioperative antibiotics ((underwent same types of operations i.e.:clean contaminated & contaminated) , the incidence of wound infection was 11.8%(59 patients)