Postoperative Wound Infections: A Study of Bacteriology and Pathogenesis

Of 200 patients, 6.5% were skin carriers of Staphylococcus aureus and 3.5% became skin carriers after admission. Development of skin carrier state was associated with a long preoperative hospital stay. A second study of 275 cases showed that skin carriers of S. aureus had a significantly higher subsequent staph wound infection rate than non-carriers, but nose and/or throat carriers of S. aureus did not. Peroperative wound contamination was a significant factor in the subsequent development of wound infection. In clean surgery the infection rate was 5.9%. Both wound contamination and infection was due to gram positive organisms, usually S. aureus. When the gastrointestinal or biliary tract had been opened, the infection rate was 28%, the usual contaminating and infecting organisms were enteric and only occasionally S. aureus. There is a need for improved methods of minimizing peroperative wound contamination.