Prevention of Surgical Site Infections After Elective Laparotomies

Aim of study. To evaluate the effectiveness of the proposed method for preventing surgical site infections (SSI) and reducing postoperative pain.

Material and methods. A randomized clinical study was conducted, including 58 patients from the medium and high-risk groups for developing SSI, who underwent midline laparotomy from January 1, 2024, to May 15, 2024, at two institutions: Ulyanovsk Regional Clinical Hospital and Ulyanovsk Regional Oncological Dispensary.

Results. Univariate statistical analysis revealed that patient clinical data—gender, age, type of surgical intervention, and comorbidities — were not statistically significant. Analysis of laboratory parameters — including the leukocyte intoxication index according to V.K. Ostrovsky, neutrophil-lymphocyte ratio (NLR), plateletlymphocyte ratio (PLR), C-reactive protein (CRP) level, and cortisol level — were significantly lower on the 5th day in the experimental group, which was statistically significant. Additionally, the incidence of surgical site infections was significantly lower in the experimental group (3/29, 10.3%) compared to the control group (7/29, 24.1%), p=0.03. No differences were found between the groups in the structure of infectious complications at the surgical site. During statistical analysis, it was determined that in the study group, the Visual Analogue Scale (VAS) score on the third postoperative day was significantly lower than in the control group (p=0.048).

Conclusion. The use of the proposed method in clinical practice during midline laparotomy may be an effective and safe technique for preventing surgical site infections and reducing postoperative pain.

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