Postoperative clostridial infections in Britain

Abstract

Eighty-five cases of clostridial infection, including 56 cases of gas gangrene, followed "clean" surgical operations performed in British hospitals in the course of two years. Nearly all the serious infections followed amputations of the leg for ischaemia or other operations on the leg in which a foreign body was implanted. All the infections were sporadic, and the evidence suggested that the infecting organism usually came from the bowel of the patient. Nearly half of the operations were performed in modern theatres with satisfactory ventilation and unexceptionable arrangements for the sterilization of instruments and dressings.Skin sterilization was often carried out perfunctorily or with agents with poor sporicidal activity. Total eradication of spores from the skin is, however, difficult to achieve, and recontamination may occur during the operation. Hence it is considered justifiable to give penicillin prophylactically to the small group of patients at serious risk from postoperative gas gangrene.