[Bacterial count as an infection prognostic factor in the delayed primary closure of abdominal surgical wounds]. / La cuenta bacteriana como factor pronóstico de infección en el cierre primario tardío de heridas quirúrgicas abdominales.

ABSTRACT

STUDY OBJECTIVE: To determine the prognostic value of the soft-tissue biopsy to handle contaminated or infected surgical wounds with delayed primary closure. DESIGN: Comparative, prolective, blind and observational. PLACE Referral tertiary care center. PATIENTS We included 70 patients distributed in two groups Group I 50 patients who underwent contaminated or infected abdominal surgery; and Group II 20 patients who underwent clean or clean contaminated abdominal surgery and developed surgical wound abscess. INTERVENTIONS: Daily cleaning and water irrigation and periodic debridement were done in all the cases; after five days (excluding infection), two tissue biopsies for quantitative culture and wound closure were performed. MEASUREMENTS AND MAIN RESULTS: In Group I, nine of 26 patients (35%) with positive culture (greater than 10(5) colony forming units/g) developed infection and none of 24 with negative culture (p less than 0.01, Fisher); the negative predictive value (nPV) was 100% and the positive predictive value (pPV) was 35%. In Group II, seven of 12 patients with positive culture and one of eight with negative culture developed infection (p less than 0.05); the nPV was 87% and the pPV was 58%. CONCLUSIONS: The biopsy of soft-tissue seems to be a helpful tool for the treatment and prognosis of infected or contaminated surgical wounds.