SPLENECTOMY - A CLEAN OPERATION

To determine the factors causing wound infections after splenectomy, 2 11 patients undergoing surgery during 1982-1991 were studied in two gr oups: - Patients with clean-contaminated or contaminated operations wi th additional splenectomy in the same session; - Patients with electiv e splenectomy only. While in the first group the rate of disorders of wound healing (DWH) was 31.6%, the second group had a rate of 8.15%. T his rate was higher than for other clean operations in our hospital an d was as high as for clean-contaminated operations such as cholecystec tomy. Among the patients older than 60 years, 38.2% had DWH, as agains t 8.9% of the patients younger than 60 years. The mean operating time in patients with wound infections was 223 min, while the mean operatin g time in patients without infections was 125 min. In patients with wo und infections the gamma-GT was higher than in patients who had no inf ection. After these results we have given 2 g ceftriaxon as single-sho t prophylaxis before every splenectomy. Since starting this, we have p erformed 28 splenectomies, and DWH has been observed in only 1 (3.57%) . We therefore recommend antiobiotic prophylaxis.