Volume 20, No. 1, 2023
Study Of The Role Of Sepsis And Antibiotics In Fistula In Ano : Our Experience In Tertiary Care Hospital In North India
Hilal Ahmed, Aqib Amin, Simran Shafi*, Inzmam Wani, Fazl Q Parray, Shujaut Farooq
Abstract
Fistula in Ano is a persistent aberrant communication between the perianal skin and often the epithelized surface of the anal canal. The two important concerns about fistula treatment are high rate of recurrence and postoperative incontinence. Objectives: To study the Bacteriological flora in patients of fistula in Ano, the Antibiotic sensitivity of the infecting organism in such patients and role of Prophylactic antibiotics on wound healing in such patients. Materials and method: Prospectively all the patients of both sexes and all age groups presenting with fistula in ano needing surgical intervention from August 2020 to June 2022 were included in this study. Patients were divided into two groups, Viz group-A and group-B, with the help of computergenerated randomization numbers. Group-A patients received prophylactic broad-spectrum antibiotics covering empirically both aerobic and anaerobic bacterial pathogens while as group-B patients did not receive any prophylactic antibiotics. However postoperative regular antiseptic dressing, antibiotics adequate self-washing and Sitz baths were given to patients of both groups. The patients of both groups were followed postoperatively at 2,4,6 weeks and 3 and 6 months to assess the outcome of various surgical procedures. The bacteriological swab was sent for culture/ sensitivity for every newly admitted patient with purulent discharge, if intra operatively any patient had any perifistular collection, that was sent for culture/sensitivity, however post operatively swab was sent from every patient on 3rd POD. The culture sensitivity swabs were repeated after 2nd, 4th and 6th week after surgery. Results: Out of 120 patients, 15 patients with cases 07 (5.8%) and controls 8 (6.6%) developed recurrence. Incontinence (both minor & major) was observed in 12 patients (6 patients in each group) over a mean follow-up of 12 months. In our study of 120 patients operated, a total of 15 patients had a recurrence of disease. Recurrence was found mostly in those patients who had post-operative surgical site infection. Recurrence was found associated with type of organism isolated with Escherichia coli being most common (33.3%) followed by bacteroid species (26.6%)
Pages: 40-49
Keywords: Antibiotics