Risk of Infection after Penetrating Abdominal Trauma

TLDR

Purpose/Mechanism combined in first line: The study aims to identify risk factors for postoperative septic complications in patients with intestinal perforation after abdominal trauma and compare single vs dual antibiotic prophylaxis. So sentence: "The study examined 145 patients with abdominal trauma and intestinal perforation to identify risk factors for postoperative sepsis and compare the efficacy of single‑drug versus dual‑drug antibiotic prophylaxis." That covers both. Key points: higher risk associated with older age, left colon injury requiring colostomy, more blood transfusions, more injured organs. Shock on arrival not predictive.

Abstract

To identify the risk factors for the development of postoperative septic complications in patients with intestinal perforation after abdominal trauma, and to compare the efficacies of single-drug and dual-drug prophylactic antibiotic therapy, we studied 145 patients who presented with abdominal trauma and intestinal perforation at two hospitals between July 1979 and June 1982. Logistic-regression analysis showed that a higher risk of infection (P<0.05) was associated with increased age, injury to the left colon necessitating colostomy, a larger number of units of blood or blood products administered at surgery, and a larger number of injured organs. The presence of shock on arrival, which was found to increase the risk of infection when this factor was analyzed individually, did not add predictive power. Patients with postoperative sepsis were hospitalized significantly longer than were patients without infection (13.8 vs. 7.7 days, P<0.0001). Both treatment regimens — cefoxitin given alone and clindamycin and gentamicin given together—resulted in similar infection rates, drug toxicity, duration of hospitalization, and costs. (N Engl J Med 1984; 311: 1065–70.)