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Category: Volume 07 Issue 06 June 2019
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Title: Impact of Pressurised pulse jet wound irrigation with Normal saline in Laparotomy wounds on Surgical site infections in comparison with standard wound irrigation techniques: A prospective trial

Authors: Dr Ravindran Chirukandath, Dr Sharath Kumar V, Dr Vinod .M, Dr Sarath Krishnan, Dr Nimisha, Dr Agestino

 DOI: https://dx.doi.org/10.18535/jmscr/v7i6.33

Abstract

      

Surgical site infections is a dangerous condition causing a heavy burden on the patient and social health system. Such infections lengthen the hospital stay for an average of seven days and results in higher costs. Surgical site infections are among the most common hospital acquired infections comprising 14 to 16% of inpatient infections

There are various factors predisposing the infections and many of them are patient related or disease related. The Inoculation of bacteria to surgical sites forms One of the most important factors .In orders to reduce the infection One of the ways area thorough clearance of bacterial load from the wound before closure.Wound irrigation is the steady flow of a solution across an open wound surface meant to remove cellular debris and surface pathogens contained in wound exudates or residue from topically applied wound care products. The other method is Pressurized pulse irrigation of subcutaneous tissues may lower infection rates by aiding in the debridement of necrotic tissue and reducing bacterial counts.

This study compared the incidence of surgical site infections within 7days of postoperative period in laparotomy wounds irrigated using pressurized pulse jet saline irrigation  (<15 psi with 2 L normal saline) and  those subjected to other standard wound irrigation  techniques, immediately prior to skin closure .

This study compared128 Pulse irrigation patients and 110. Standard irrigation patients undergoing various elective n=111 and emergency procedures n=127. The overall SSI rates in 7 days in the whole group was 32/238 (13.44 %) . The SSI rates on the pulse irrigation group was 13/128 (10.16%) and Standard irrigation group was 19/110 (17.27%) and it was statically significant with a p Value of P = ..00413 showing significant reduction in the pulse group. The study also compared the SSI rates in elective and emergency procedures in both groups with significant difference in Emergency procedures. More variables are also compared between the groups and results were analyzed.

More refinement in techniques and more rationale research into the various groups of patients will be of more value in this field. This study shows an innovative simple approach can be of effectiveness in reducing the morbidity of one of the most common cause of Post of morbidity and complication in laparotomy patients

Keywords: SSI, Pulsed jet irrigation.

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Corresponding Author

Dr Ravindran Chirukandath

Additional Professor of Surgery, Government Medical College, Thrissur, Kerala, India