Surgical Wounds: A Case Study

The presence of a suture in a surgical wound has been found to increase the tissue's susceptibility to infection.(10) (3) Occurrence of bacteria inside a wound does not always implicate an infection. Altemir and Culbert(29) have suggested that the infection risk depends upon the host resistance, bacterial contamination and virulence of the organism. In human volunteers, Elek and Conen(3) have noted that an injection of 106 Staphylococcus pyogenes was required to elicit a pus-forming clinical infection. When a silk sutures was introduced into the same conditions only 100 staphylococci were enough to form pus. The results of this study indicate that the introduction of staphylococci on a silk suture can enhance the development of infection as much as 10,000 fold.

Wound closure materials enhance the infection rate in various ways. The tissue-handling technique have a significant effect on the infection rate. It is believed factors like if the suture is kept too tight and the inflammatory response of the tissues due to the passage of the needle heightens the risk of infection(25). Incidence of wound infection also depends on the physical morphology and chemical

These findings were in accordance with a study conducted by Edmiston et al(11) who found that common organisms colonizing infected sutures include Serratia spp, coagulase-negative staphylococci, Staphylococcus aureus, , Pseudomonas aeruginosa, Peptostreptococcus spp, Escherichia coli, Staphylococcus epidermidis, Bacteroides fragilis and Serratia spp. Although a skin commensal ,it is siginificant to know that staphylococci are responsible for a number of skin infections(32) (33) and will undoubtebly play a role in causing a wound infection in presence of a suture. Gram negative organisms such as Klebsiella, pseudomonas are non- commensals having a role in skin