Bacteriological Pattern and Determinants of Wound Infection following Maxillofacial Surgery

Objective:  To determine the occurrence of wound infection following oral and maxillofacial surgery.

Method: This was an experimental based study where bacteriological Isolate was collected using sterile swab stick from infected wound following oral and maxillofacial surgery. Demographic and other relevant clinical information were sought from patient’s case notes. Descriptive statistics was obtained for all variables documented. Multivariate analysis and statistical testing was used to estimate the strength of correlation of some variables. Analysis of variance (ANOVA) and Duncan’s multiple range as well as chi-square tests were appropriately applied. The confidence level was set at 95% and probability values (P-value) of P<0.05 was regarded as significant.

Result: Two hundred patients were evaluated. The overall infection rate was 10%. Significant increase was seen in surgical site infection rate with an increase in the length of hospital stay. Surgical site infection rate was much higher (43.8%) in cases where a surgical drain was used than in non-drained wounds (7.0%). The most common isolate was staphylococcus aureus followed by Pseudomonas aeruginosa. Sensitivity to third generation cephalosporins and quinolones was high and Amoxycillin, was effective with 56.3% of the organisms found to be susceptible to its antimicrobial action. There was no significant correlation between preoperative, intraoperative as well as immediate postoperative bacteria culture and subsequent wound infection.

Conclusion: There was significant correlation between postoperative wound infection and age of patient, duration of surgical intervention, the use of and duration of use of surgical drain, class of surgical wound and length of hospital stay. There is need for a post discharge surveillance system for postoperative wound infection.  This would provide a database for determining the rate of postoperative surgical site infection in our hospitals and establishing local guidelines.